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Australia's Flesh-Eating Ulcer Epidemic Is Baffling Medical Experts

Australia's flesh-eating ulcer epidemic has increased significantly in Victoria in recent years, and now the puzzling disease is spreading into new areas, including near Cairns in Queensland.

WARNING, GRAPHIC CONTENT: 

The Buruli ulcer is an infection that eventually leads to painful skin ulcers that fail to heal. It starts out looking and feeling like a mosquito bite, but often ends up leaving coin-sized open wounds.

This flesh-eating bacteria, Mycobacterium ulcerans, is related to the infection that causes leprosy that paralyses the immune system.

In 2018 there were 340 cases of Buruli ulcer reported in Victoria. This compares with 277 cases in 2017 and 89 cases in 2014.

This year there have been 240 cases of Buruli ulcer thus far.

The state's health department said it has seen a rapid increase in cases of Buruli ulcer between 2015 and 2018 -- with most cases linked to the Mornington Peninsula.

However, a number of recent cases have emerged in Geelong, Victoria's second-largest city.

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The disease causes lesions and "skin disintegration as the [patient's] flesh".

"Endemic areas include the Bellarine and Mornington Peninsulas, but recent cases suggest that Aireys Inlet (Surf Coast) and the Geelong suburb of Belmont are possible new areas of local transmission." Victoria's Chief Health Officer Dr Brett Sutton said on Thursday.

Scientists don't really understand why it's in Victoria because for the rest of the world it's in the tropical areas including rural West Africa, Central Africa, New Guinea, Latin America and tropical regions of Asia.

Some early research suggests that possums and mosquitoes may be involved in spreading the disease, however, there may be other or multiple ways the disease is spread.

"The exact mode of transmission is still unclear, but there is increasing evidence that mosquitoes play a role so avoiding mosquito bites is recommended," Sutton said.

Sutton also announced free tests are now available to Victorians who suspect they may have the disease.

A severe Mycobacterium ulcerans lesion on the knee of an 11-year-old boy. The flesh-eating bug causes an infectious disease called Buruli ulcer. Image: AAP

In Queensland, the condition is also known as the Daintree ulcerand while the northern state experienced a spike of 54 cases in 2011, the number of people infected has declined to just a handful of cases.

However this year, three cases of the disease have emerged south of its usual catchment area in the state's far-north. The new Queensland cluster has broken out in the tiny Atherton Tableland town of Julatten.

This development is further compounding the confusion surrounding the disease.

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Although Buruli ulcer is not fatal, the infection can leave people with significant cosmetic and sometimes functional damage to limbs. It is also not spread person-to-person.

Living in or visiting an affected area is the most important risk factor for contracting the disease, and people can potentially contract the Buruli ulcer from a single visit.

If you want to protect yourself from the disease health experts suggest the following:

  • Wear covering clothing that reduces contact with biting insects;
  • Use insect repellent on exposed skin;
  • Clean and cover cuts and abrasions;
  • Remain aware if you live in or visit areas where the ulcer is more common;
  • Ask your doctor about the ulcer if you think you have one - there is a fast and accurate diagnostic test available (now free in Victoria).

Australian researchers are intensifying their search for answers around the puzzling condition.

Experts have been collecting soil samples and faecal samples from possums in the Mornington Peninsula Shire as well as laying mosquito traps.

The research team are also on the hunt for local residents to take part in the case-control study by filling out a questionnaire, looking at possible risk factors and understanding how people may become infected.

Contact the author alattouf@networkten.com.au