Abstract
Buruli ulcer (BU) is a destructive soft-tissue infection caused by the environmental pathogen Mycobacterium ulcerans. In response to rising BU notifications in the state of Victoria, Australia, we reviewed all cases that occurred during 2011–2016 to precisely map the time and likely place of M. ulcerans acquisition. We found that 600 cases of BU had been notified; just over half were in residents and the remainder in visitors to defined BU-endemic areas. During the study period, notifications increased almost 3-fold, from 66 in 2013 to 182 in 2016. We identified 4 BU-endemic areas: Bellarine Peninsula, Mornington Peninsula, Frankston region, and the southeastern Bayside suburbs of Melbourne. We observed a decline in cases on the Bellarine Peninsula but a progressive increase elsewhere. Acquisitions peaked in late summer. The appearance of new BU-endemic areas and the decline in established areas probably correlate with changes in the level of local environmental contamination with M. ulcerans.
Highlights
Buruli ulcer (BU) is a destructive soft-tissue infection caused by the environmental pathogen Mycobacterium ulcerans
Buruli ulcer (BU) is a destructive skin and soft tissue infection caused by Mycobacterium ulcerans
We describe the recent epidemiology of all known cases of BU in Victoria that occurred during 2011–2016
Summary
Buruli ulcer (BU) is a destructive soft-tissue infection caused by the environmental pathogen Mycobacterium ulcerans. In response to rising BU notifications in the state of Victoria, Australia, we reviewed all cases that occurred during 2011–2016 to precisely map the time and likely place of M. ulcerans acquisition. Buruli ulcer (BU) is a destructive skin and soft tissue infection caused by Mycobacterium ulcerans. The primary risk factor for acquisition of BU is residence in or visitation to a BU-endemic area; the environmental reservoirs and modes of transmission within these areas are not completely understood. We aimed to accurately map current and new BU-endemic areas and compare and contrast the changing incidence in these locations, to document disease severity and associate this with diagnostic delay, and to identify times of increased transmission risk
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