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What To Know About Buruli Ulcer, A Flesh-Eating Disease Spreading In Australia

Recently, a disease spreading in parts of Australia named 'Buruli ulcer' is making headlines around the world. The chief health officer of Victoria (a state in southeast Australia), Professor Brett Sutton has issued a warning for residents and health professionals of the area where most of the cases of the disease has been detected.

So, what is a Buruli ulcer? In this article, we will discuss this disease and its related causes, symptoms and other details. Take a look.

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What Is Buruli Ulcer?

Buruli ulcer is a necrotising disease caused by a bacterium named Mycobacterium ulcerans. It is one of the neglected skin-related tropical diseases that may cause disabling of the person. A study says that around 60000 cases of Buruli ulcer have been detected in 33 countries between 2002 to 2017.

This skin disease typically starts with a papule, nodule, plaque or lesion and aggravate to a sever skin ulceration. The unique aspect of Buruli ulcer is in spite of the extent of tissue loss, the lesions are usually painless or with limited pain. [1]

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The condition resolves in some without the treatment, while in others, Buruli ulcer can cause disfigurement and long-term disability and also social stigmatisation, the reason why it is known as 'bankruptcy wound'.

People in tropical countries such as West Africa or in countries with subtropical and temperature climates like Australia get mostly infected with the bacteria.

Causes Of Buruli Ulcer

The bacterium Mycobacterium ulcerans cause Buruli ulcer by producing a harmful toxin called nycolactone. This toxin prevents phagocytosis, a process in which the cells, especially white blood cells ingest the harmful particles and kills them.

Also, it delays the inflammatory response and causes cell death. In the absence of an inflammatory response, the body is unable to defend the pathogens, which then replicates and infect most of the tissues.

The Buruli infection is known to spread rapidly in the limbs, trunk or head. The transmission of the bacterium is a mystery but some research has shown that the spread can be through skin contact with certain rivers, ponds and mud, especially in the rainy season. [2]

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Studies on the bites of water insects have also been carried out, but the direct transmission from the insect to humans has not been clearly depicted.

Another study establishes the link between Buruli ulcer and mosquitoes. It says that during the previous outbreak of the condition in Victoria, the bacterium was detected in mosquitoes through a PCR test. However, the study was established in relation to environmental factors that promote other vector-borne diseases and said that Buruli ulcer can also spread in the same manner i.e via mosquitoes. [3]

Buruli ulcer bacterium starts replicating in the subcutaneous tissues when the temperature reaches 30-33 degree-Celcius.

Symptoms Of Buruli Ulcer

Some of the symptoms of Buruli ulcer include:

  • Necrosis or death of soft tissues of the skin
  • Swelling of the skin
  • Painless ulcers or nodules
  • One or more slow-growing ulcers

Risk Factors Of Buruli Ulcer

  • People staying in areas with tropical, subtropical, and temperate climates such as sub-Saharan Africa.
  • Children below 15 years of age
  • People with a suppressed immune system

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Complications Of Buruli Ulcer

If left untreated, Buruli ulcer can progress to

  • Deformity
  • Bone infection
  • Disability of the joints
  • Spread of skin ulcer to other body parts.

Treatments Of Buruli Ulcer

  • Oral antibiotics: Some oral antibiotics such as rifampicin in combination with clarithromycin can help prevent the aggravation of the lesions. [4]
  • Surgery: Antibiotics when combined with surgical treatment can help in treating the condition at the earliest. Some of the methods include debridement, skin grafting and wound care. Also, frequent dressing and support are needed to treat the condition.
  • Other medications: It includes medications to treat swelling.

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How To Prevent Buruli Ulcer

Some fo the preventive measures include: [5]

  • Wearing long sleeves and trousers
  • Using mosquito repellents, especially if the disease is endemic in the area where you are residing.
  • Visiting a medical expert if you notice any kind of skin abrasions.
  • Getting vaccination every year for M. ulcerans bacterium.
  • Staying away from ponds and lakes.

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To Conclude

Buruli ulcer is endemic in certain areas, but with the introduction of antibiotic treatment, the condition is managed to a large extent. Also, with the earlier detection of the condition, deformity or complications related to the condition can be controlled.

Story first published: Thursday, February 25, 2021, 19:00 [IST]