Researchers have identified Batemans Bay on the New South Wales (NSW) South Coast as potentially new hotspot for Buruli ulcer, raising alarms over the emergence of this flesh-eatting condition, previously thought to be confined to areas like Victoria.
Buruli ulcer, caused by the bacterium Mycobacterium ulcerans, leads to progressive skin and soft tissue infections and has been largely contained before now, but the recent findings published in the journal PLOS Neglected Tropical Diseases signal troubling developments. The study showcased two cases of Buruli ulcer detected locally, which highlight the area's risk of becoming endemic for the disease. This new research was conducted by infectious disease specialists from various institutions—Canberra Health, the Doherty Institute, the University of Wollongong, NSW Health, and Austin Health.
This alarming development follows the history of Buruli ulcer primarily situated along the Victorian coast, with over 347 confirmed cases reported just this year alone. This figure starkly emphasizes the need to understand the mechanisms driving this bacterial infection.
Historically, Buruli ulcer has been detected across various regions, including the more tropical climates of North Queensland and the Northern Territory, but its new appearance along the south coast of NSW has thrown authorities and researchers alike, both local and interstate, on high alert.
Dr. Mehrab Hossain, the infectious disease physician and lead author of the study, expressed concern when she stated, "The new cases we report here in Batemans Bay could be a harbinger of disease expansion," indicating not just the mere existence of the bacteria but potential future growth.
Genomic analysis of the bacterial samples revealed significant findings, with Professor Tim Stinear of the University of Melbourne noting, "Genome sequencing of samples from the Batemans Bay cases provided important clues about the infections." The genomic links identified show the bacteria causing the recent infections were genetically related to previous cases recorded near Eden, about 150 km south of Batemans Bay. This specific genetic lineage diverges from the prevalent strains found around Victoria, including Melbourne and Geelong.
These findings raise troubling questions about how the disease could bridge such distances, sparking federal and state health officials to increase vigilance. The growing consensus among experts suggests this spread could closely mirror patterns seen previously as Buruli ulcer expanded from coastal towns to urban settings, as it did across parts of Victoria.
This bacterium is not just terrifying because of its damaging impacts—it can prompt ulcers and extensive skin deterioration, requiring prolonged treatments. If caught early, the disease is treatable with antibiotics, but diagnosis can be challenging. Professor Paul Johnson from Austin Health emphasized the need for public vigilance, saying, "If you have been in an endemic area and notice a progressive sore, it’s time to discuss the possibility of Buruli ulcer with your doctor."
Symptoms often take months to manifest post-infection, with the initial stages frequently mistaken for less serious skin complaints. The infection often commences as a benign lump, easily confused with insect bites. Yet, it can escalate rapidly, burrowing through skin layers leading to serious and deep ulcers—thus earning its sinister nickname as the "flesh-easting" disease. Unfortunately, if it is left untreated for too long, the sores can become quite severe and lead to significant morbidity.
The study even pointed out the fact to support the suspicion of local transmission—researchers found evidence of the bacteria (
u}. ulcerans) within possum feces sampled from the area. It is believed these possums are pivotal vectors transmitting this dangerous infection between themselves and potentially to humans through mosquito bites. The analysis found 27 samples of possum excreta tested positive for the bacterium, indicating their significant role in the ecological chain leading to Buruli ulcer cases.
Experts are urging residents of Batemans Bay and surrounding areas to exercise precautionary measures to minimize the risk. These include wearing protective clothing outdoors, applying mosquito repellent, and maintaining good wound care practices. "We don’t know if Buruli is going to spread in NSW, but it certainly is a possibility we need to be prepared for," warned Dr. Anton Forsyth, senior medical advisor at Murrumbidgee Local Health District.
While researchers map the disease's transmission, increased public health awareness is pivotal. The recruitment of the community for vigilance can help combat widespread outbreaks against Buruli ulcer. While emergency responses are already activated to educate the public, monitoring at-risk mosquito-prone areas becomes even more pressing.
There is hope, with public health advocates stressing the measures available, “While Buruli ulcer can be serious, it’s always treatable, with appropriate antibiotics and care.” Their rallying cry not only raises awareness of this potentially devastating disease but focuses on local precautions to manage risks.
The emergence of Buruli ulcer as potentially endemic within Batemans Bay serves as both warnings and calls to action for both local residents and broader NSW health communities. With the growing environmental and health concerns posed by infectious diseases, the lessons and statistics from Victoria are perhaps the best roadmap to chart future responses within this new epidemiological framework.
