Buruli Ulcer – The Flesh-Eating Ulcer Outbreak Spreading Across Australia

Buruli Ulcer is a type of flesh-eating ulcer that can dissolve you to the bone.

This flesh-eating ulcer has been seen in Australia since the 1930s and is more prominent during the Australian summer season.

The skin infection is predominantly found in Victoria, with 240 cases in 2019.

Buruli Ulcer
Buruli Ulcer – The Flesh-Eating Ulcer

In this article, you will find a summary of Buruli Ulcer, its symptoms, cures, and prevention methods.

You can also visit the Victorian Health website for the latest updates on this skin disease (1).

What Is Buruli Ulcer?

Buruli ulcer is a skin and soft tissue infection that’s caused by the Mycobacterium ulcers bacteria.

It is also known as Bairnsdale ulcer and Daintree ulcer in Queensland. But in layman’s terms, it’s a flesh-eating bacterium that’s capable of quickly eating through the flesh and bone of its victims.

A disturbing fact about this flesh-eating ulcer is that it’s from the family of bacteria that also cause tuberculosis and leprosy and can increase the risk of these diseases.

How Does Buruli Ulcer Eat Through Flesh?

  1. After infection, the bacterium produces a toxin that inhibits immune response while destroying the fat cells that are under the skin.
  2. The damaged soft tissue causes painless local redness and swelling along with a lump (sometimes).
  3. This can turn into an ulcer that slowly spreads as it eats through the surrounding tissue.
  4. If not treated, the damaged skin and soft tissue die, turn black, and flake off.
  5. This reveals patches of missing skin and flesh.

That said, Buruli Ulcer isn’t fatal. But this is not a consolation for those who are affected as this can cause cosmetic and sometimes function damage to the body.

Imagine having your bicep muscles eaten through to the bone. How would you even be able to lift your arm to function like you usually would?

Thirty-three countries around the world have reported having cases of Buruli Ulcer. The highest number of cases being from Australia, Nigeria, and Ghana (2).

Buruli Ulcer In Australia:

Buruli Ulcer was first reported in Australia in the 1930s in the Bairnsdale area of East Gippsland. This is also where it got its name as Bairnsdale ulcer.

By 2012, the flesh-eating ulcer infection had reached Philip Island, Bellarine Peninsula, Mornington Peninsula, and Southeastern bayside suburbs that are closer to Melbourne.

Map of Buruli Ulcer transmission risk-levels in Melbourne suburbs
Map of Buruli Ulcer transmission risk-levels in Melbourne suburbs (Updated 31st Oct 2019)

Risk levels of Buruli Ulcer transmission in Melbourne suburbs:

  • High-risk: Rye, Sorrento, Blairgowrie, and Tootgarook
  • Moderate-risk: Frankston, Seaford, Ocean Grove, Barwon Heads, Point Lonsdale, Queenscliff
  • Low-risk: South Eastern Bayside suburbs, East Gippsland, Bellarine Peninsula, and Mornington Peninsula

A few days back, there was a call to have health warning printed on individual cigarettes of the risks of Buruli Ulcer (3).

Unlike last year, this year, there are also reports of the infection being reported in Blemont and Aireys Inlet near Geelong. This has caused a concern that may indicate the area of transmission is spreading (4).

That said, Victoria’s Chief Health Officer, Brett Sutton, in a recent interview said: “There have been a small number of cases detected in these areas [Blemont and Aireys], but the risk of transmission remains low.”

The number of cases of Buruli Ulcer in Victoria:

  • 182 cases in 2016
  • 277 cases in 2017
  • 340 cases in 2018
  • 240 cases in 2019

Compared to last year, the number of cases of Buruli Ulcer has dropped in 2019. Additionally, while there are cases diagnosed year-round, the peak period for the flesh-eating ulcer infection is between June and November in Australia.

Children under the age of 15 are also at greater risk of the infection.

Signs Of Buruli Ulcer:

Like many infections, it can take four weeks to up to nine months for the disease to go through its incubation period. This makes it that much harder to pinpoint where and when someone got infected.

A painless bump on the skin, much like an insect bite is the first sign of Buruli Ulcer. This is also why it can be confusing to detect since they look like mosquito bites.

The common skin lesions that may be Buruli Ulcer infections include lumps, pimples, red patches, or ulcers that get worse instead of healing over time.

This lesion can occur anywhere on the body. However, it’s most commonly found on the arms, legs, and face.

It can take 1-2 months for the lesion to become an ulcer that eats away at the flesh.

Signs Of Buruli Ulcer
Buruli Ulcer can spread quickly to eat away at large chunks of flesh.

While most cases occur with only painless nodules, some can come with painful humps, severe pain, or fever.

Oedematous lesions are the most severe form of this disease, but also the least common.

Transmission, Detection, And Cure:

Very little is known about the transmission of this bacterial infection.

Some experts indicate that the bacteria are more common near stagnant water-bodies (5). Mosquito bites and open wounds are also a possible entry point for the bacteria.

There is also a 2-year research project that’s currently underway in Australia called Beating Buruli in Victoria. This project is trying to finding out the transmission of and cure for Buruli Ulcer (6).

However, there is no known cure, as of yet, for Buruli Ulcer (7).

Preventative Measures Against Flesh-Eating Ulcer:

The best way to handle Buruli Ulcer is to take active steps at preventing infection.

Buruli Ulcer Risk
Taking the right steps can reduce the risk of Buruli Ulcer infection.
You can reduce your risk of Buruli Ulcer infection by:
  • Avoid insect bites by using insect repellent and fly screens.
  • Wearing long sleeves and covering up exposed skin when outside also helps.
  • Wear the right protective gear when you are in the endemic areas when outdoors
  • Clean out the cuts and abrasions promptly

While there is no reason to panic if you happen to be in an area where Buruli Ulcer has been reported, you should still take the necessary precautions.

In addition, visit your doctor ASAP if you notice any skin lesions after having visited an endemic area.

For additional information on Buruli Ulcer, the flesh-eating ulcer disease, visit the WHO and Victoria Public Health websites (8, 9).

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Jessica J
About Jessica J 131 Articles
Written & Reviewed by Jessica J, M. D. Dermatology.

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