Flesh eating ulcer cases on the rise in Victoria

By Dr. Ananya Mandal, MDApr 16 2018

Recent reports have shown a rise in cases of flesh eating ulcers in and around Victoria, Australia. Health experts have said that this could become a serious problem if not handled carefully. They have called for funds to deal with this menace. These flesh eating ulcers, according to sources have infected hundreds of individuals in regional Victoria.  

According to the reports, there has been a 400 percent rise in the incidence of these flesh eating ulcers in the past four years. For example there were only 182 reported cases of this ulcer in 2016. Until November 2017, the numbers rose to 236. The bacteria that cause these ulcers are called Mycobacterium ulcerans (MU). According to experts, this condition is poorly understood and thus diagnosis and treatment is difficult.

Image Credit: Buruli ulcer in a long-term traveler to Senegal. Image Credit: CDC

These bacteria are found in the Bellarine and Mornington peninsulas of Victoria. The bacteria are found abundantly in west or central Africa especially from Benin, Cameroon and Ghana. This infection was more prevalent in these regions. The bacteria infect possums that then transmit it to humans via mosquito bites.

According to Daniel O'Brien, who is an infectious diseases expert and the executive director of infectious diseases at Barwon Health, wrote on this condition in the latest issue of the Medical Journal of Australia. He that these flesh-eating ulcers are called Buruli ulcer and they need urgent government action and funding for timely detection and treatment. He wrote that these infections commonly start over the arms or legs as a non-healing sore or a blister. From there it begins to enlarge until it turned into a non-healing ulcer. He explained that it can eat away into the skin and the soft tissues under the skin. As it eats into the muscles, it may affect movement of the affected region. When less deep, it can leave behind ugly scars. Surgery may be necessary to remove all of the affected tissue. In few cases, this ulcer may be associated with death. “So it's actually really a serious infection,” said O'Brien.

Associate Professor O'Brien and several other researchers have called for government action to combat the spread of this infection. He said that the process of spread, transmission in new areas, location and pathophysiology needs to be understood clearly. He called this a “serious epidemic” and said, “It's very difficult to prevent it and address it with effective public health interventions if we don't know that really basic scientific information.” People of all ages are affected he said.

Victoria's Deputy Chief Health Officer, Brett Sutton from Department of Health and Human Services, said in his statement that till date almost $800,000 has been spent researching this ulcer. He added that the money also helped raising awareness among the general public and warn people about mosquito bites. He said in a statement, “Certainly it's a serious illness, I'm acutely aware of the rising cases… Our attention's absolutely on it and we're well aware of what an issue it is.” As of now, raising public awareness, mosquito control and detection of infected possums is top priority as well as understanding the infection better, say experts in the field.

References: https://www2.health.vic.gov.au/public-health/infectious-diseases/disease-information-advice/mycobacterium-ulcerans