The emergence of<i>Mycobacterium ulcerans</i>infection near Melbourne

Johnson, Paul D R; Veitch, Mark; Leslie, David; Flood, Paul; Hayman, John

doi:10.5694/j.1326-5377.1996.tb101352.x

Cited by 76 publications

(57 citation statements)

References 10 publications

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“…The disease is also endemic in several other countries outside Africa, including rural areas of Papua New Guinea, Malaysia, French Guiana, and Mexico (Figure 1). In Australia, the disease remains uncommon, but there have been increases in both incidence and the number of endemic areas in the last 15 years [13,14]. …”

Section: History and Epidemiologymentioning

confidence: 99%

Buruli Ulcer (M. ulcerans Infection): New Insights, New Hope for Disease Control

Johnson¹,

Stinear²,

Small³

et al. 2005

PLoS Med

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Section: History and Epidemiologymentioning

confidence: 99%

Buruli Ulcer (M. ulcerans Infection): New Insights, New Hope for Disease Control

Johnson¹,

Stinear²,

Small³

et al. 2005

PLoS Med

Self Cite

214

219

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“…Human BU incidence in south-eastern Australia is on the increase, particularly in the last two decades [2], [8]. The progressive extension of the westernmost extremity of the endemic area from the original Bairnsdale region more than 260 km to the east, and the frequent emergence of new endemic foci are current public health concerns.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been observed that new endemic areas emerge in areas adjacent to recent soil disturbance and flooding [7]. In south-east Australia, infection is consistently associated with coastal areas [8], [9] and the mechanism of transmission remains elusive, although several studies have indicated that mosquitoes may have a role [2], [10]. The bacterium infects a wide range of terrestrial mammals in Australia, including both domestic animals [11]–[13] and native wildlife [14], [15].…”

Section: Introductionmentioning

confidence: 99%

Potential Wildlife Sentinels for Monitoring the Endemic Spread of Human Buruli Ulcer in South-East Australia

et al. 2014

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The last 20 years has seen a significant series of outbreaks of Buruli/Bairnsdale Ulcer (BU), caused by Mycobacterium ulcerans, in temperate south-eastern Australia (state of Victoria). Here, the prevailing view of M. ulcerans as an aquatic pathogen has been questioned by recent research identifying native wildlife as potential terrestrial reservoirs of infection; specifically, tree-dwelling common ringtail and brushtail possums. In that previous work, sampling of environmental possum faeces detected a high prevalence of M. ulcerans DNA in established endemic areas for human BU on the Bellarine Peninsula, compared with non-endemic areas. Here, we report research from an emergent BU focus recently identified on the Mornington Peninsula, confirming associations between human BU and the presence of the aetiological agent in possum faeces, detected by real-time PCR targeting M. ulcerans IS2404, IS2606 and KR. Mycobacterium ulcerans DNA was detected in 20/216 (9.3%) ground collected ringtail possum faecal samples and 4/6 (66.6%) brushtail possum faecal samples. The distribution of the PCR positive possum faecal samples and human BU cases was highly focal: there was a significant non-random cluster of 16 M. ulcerans positive possum faecal sample points detected by spatial scan statistics (P<0.0001) within a circle of radius 0.42 km, within which were located the addresses of 6/12 human cases reported from the area to date; moreover, the highest sample PCR signal strength (equivalent to ≥106 organisms per gram of faeces) was found in a sample point located within this cluster radius. Corresponding faecal samples collected from closely adjacent BU-free areas were predominantly negative. Possums may be useful sentinels to predict endemic spread of human BU in Victoria, for public health planning. Further research is needed to establish whether spatial associations represent evidence of direct or indirect transmission between possums and humans, and the mechanism by which this may occur.

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“…Cases have been reported from at least 32 countries, in regions including Africa, Australia, Southeast Asia, China, Central and South America and the Western Pacific [5]. In Victoria, cases have been reported in Gippsland, Phillip Island [6] and the Mornington [7] and Bellarine Peninsulas [8] [9] [10]. In Queensland there is a significant established focus in Far North Queensland [11] [12].…”

Section: Introductionmentioning

confidence: 99%

The Incubation Period of Buruli Ulcer (Mycobacterium ulcerans Infection)

et al. 2013

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IntroductionBuruli Ulcer (BU) is caused by the environmental microbe Mycobacterium ulcerans. Despite unclear transmission, contact with a BU endemic region is the key known risk factor. In Victoria, Australia, where endemic areas have been carefully mapped, we aimed to estimate the Incubation Period (IP) of BU by interviewing patients who reported defined periods of contact with an endemic area prior to BU diagnosis.MethodA retrospective review was undertaken of 408 notifications of BU in Victoria from 2002 to 2012. Telephone interviews using a structured questionnaire and review of notification records were performed. Patients with a single visit exposure to a defined endemic area were included and the period from exposure to disease onset determined (IP).ResultsWe identified 111 of 408 notified patients (27%) who had a residential address outside a known endemic area, of whom 23 (6%) reported a single visit exposure within the previous 24 months. The median age of included patients was 30 years (range: 6 to 73) and 65% were male. 61% had visited the Bellarine Peninsula, currently the most active endemic area. The median time from symptom onset to diagnosis was 71 days (range: 34–204 days). The midpoint of the reported IP range was utilized to calculate a point estimate of the IP for each case. Subsequently, the mean IP for the cohort was calculated at 135 days (IQR: 109–160; CI 95%: 113.9–156), corresponding to 4.5 months or 19.2 weeks. The shortest IP recorded was 32 days and longest 264 days (Figure 1 & 2). IP did not vary for variables investigated.ConclusionsThe estimated mean IP of BU in Victoria is 135 days (IQR: 109–160 days), 4.5 months. The shortest recorded was IP 34 days and longest 264 days. A greater understanding of BU IP will aid clinical risk assessment and future research.

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The emergence ofMycobacterium ulceransinfection near Melbourne

Cited by 76 publications

References 10 publications

Buruli Ulcer (M. ulcerans Infection): New Insights, New Hope for Disease Control

Buruli Ulcer (M. ulcerans Infection): New Insights, New Hope for Disease Control

Potential Wildlife Sentinels for Monitoring the Endemic Spread of Human Buruli Ulcer in South-East Australia

The Incubation Period of Buruli Ulcer (Mycobacterium ulcerans Infection)

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