New research examines risk factors for endemic flesh-eating Buruli ulcer

New research conducted in the Geelong region has uncovered risk and protective factors for a mysterious flesh-eating ulcer, as a Torquay woman shares her painful experience with the debilitating condition. WARNING: GRAPHIC

Anne Hunt was recently diagnosed with the flesh eating Buruli Ulcer. Picture: Brad Fleet

New research conducted in the Geelong region has uncovered risk factors for contracting a mysterious flesh-eating ulcer, as a Torquay woman shares her painful experience with the debilitating disease.

A study by researchers from Barwon Health, Deakin University and CSIRO examining protective and risk factors for Buruli ulcer found the chance of contracting the skin disease was more than double for individuals with diabetes.

The study found the chance of contracting the condition was nearly three times higher for those working outdoors with soil contact in known transmission areas, compared to indoor work.

But risk was lower among those with reported history of BCG vaccination, whichprovides immunity against tuberculosis caused by a different mycobacterium.

But the results of the study suggest there may also be some protection against Mycobacterium ulcerans – the bacteria causing Buruli ulcer.

The toxins made by the bacteria destroy skin cells, small blood vessels and the fat under the skin, which causes ulceration and skin loss.

Anne Hunt was recently diagnosed with the flesh-eating Buruli ulcer. Picture: Brad Fleet

The study involved 245 adults who had contracted the ulcer, who were compared to 481 people who had not had it but lived in the same areas.

It covered areas in Victoria where the ulcer is endemic and included participants from the Bellarine Peninsula and Aireys Inlet.

The ulcer was also associated with the presence of tea trees, ponds, bore water and increasing numbers of possums.

While transmission of the condition, which has been on the rise in Victoria, has not been well understood, it has previously been linked to possums and mosquitoes.

CSIRO senior research scientist Dr Kim Blasdell highlighted that this was the largest study conducted into risk and protective factors for Buruli ulcer to date, encompassing environmental, occupational and behavioural data for people living in risk areas.

Lesions are usually painless, and not all Buruli ulcers appear as ‘ulcers’ – they can be nodules or red painful swelling of limbs, often called cellulitis.

Torquay’s Anne Hunt was diagnosed with Buruli ulcer in early September, after being unwell for four weeks.

Anne Hunt's ulcer earlier on. Picture: Supplied

She initially noticed what appeared to be a spider bite on her ankle and attended a GP.

Ms Hunt was prescribed antibiotics but the “bite” continued to ache and grow.

Ms Hunt then wound up in hospital four times, being admitted twice, once for four days and later for nine.

During the final admission, after being treated for cellulitis, she was diagnosed with Buruli ulcer.

Anne Hunt's ulcer before diagnosis. Picture: Supplied

Ms Hunt is on antibiotics, is seeing a specialist and attends a GP clinic three times a week for the ulcer to be dressed.

“The pain’s been like being stabbed in the ankle with a knife,” she said.

“I can do very little – I can’t walk my dog, I can’t go to the gym.”

She was also forced to cancel a trip overseas due to immobility and risk of complications.

Anne Hunt's Buruli ulcer now. Picture: Supplied

Barwon South West public health unit epidemiologist Dr Bridgette McNamara said the study provided clinicians with more evidence that simple prevention steps could help minimise the risk of Buruli ulcer.

The study backed the effectiveness of prevention precautions such as applying insect

repellent, covering arms and legs outdoors and immediately washing wounds, and found

undertaking multiple of these protective behaviours was associated with the lowest odds of acquiring it.

Last year was Greater Geelong’s worst year on record for cases of Mycobacterium ulcerans, with 46 cases.

Greater Geelong has recorded 26 cases so far this year,while the Surf Coast has recorded four and the Borough of Queenscliffe one, according to health department data.

Originally published as New research examines risk factors for endemic flesh-eating Buruli ulcer