The danger areas. Graphic: Victoria Health
The danger areas. Graphic: Victoria Health

Insidious, flesh-eating ulcer moving

WARNING: Graphic

A hostile infectious disease that gets under skin, "makes a home for itself" and then eats away at human flesh is on the move in Victoria, experts say.

The cases of Buruli ulcer, also known as Bairnsdale ulcer, have been rising steadily for the last four years.

They were largely contained to the Bellarine and Mornington peninsulas, but the head of the team charged with combating the spread says it's jumped.

Professor Tim Stinear from the Doherty Institute at the University of Melbourne told news.com.au cases of Buruli ulcer were being reported in Melbourne's bayside suburbs.

"There have been cases appearing around Frankston, Seaford and Beaumaris in recent years. We're now seeing some patients in Blackrock and Sandringham," Prof Stinear said.

Sandringham is just 20km southeast of the Melbourne CBD.

The danger areas. Graphic: Victoria Health
The danger areas. Graphic: Victoria Health

Prof Stinear reviewed the most recent numbers on Friday this week. He said there had been "roughly 100" cases already this year.

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To put that into some context, Buruli ulcer reports totalled 107 for all of 2015. They have jumped in each year since then.

The Mornington Peninsula continues to be affected by the spread of the mysterious Buruli Ulcer, with infected patients continuing to be reported with greater numbers than the year before. Picture: Paul Jeffers
The Mornington Peninsula continues to be affected by the spread of the mysterious Buruli Ulcer, with infected patients continuing to be reported with greater numbers than the year before. Picture: Paul Jeffers

The rise in cases has led researchers to the brink of a new trial they hope will bridge a knowledge gap and answer questions about how the disease is transmitted to humans.

The Beating Buruli Project, headed up by Prof Stinear, is in the design phase of a mosquito control study. The "cluster randomised control trial" will target residential neighbourhoods with synthetic pyrethroid pesticide - a spray researchers say is perfectly safe.

They pesticide will likely be sprayed on nature strips between popular holiday suburbs Portsea and Rosebud.

Not everybody is happy about it. A change.org petition headlined "Mornington Peninsula insect massacre" has been signed more than 9000 times.

But Prof Stinear says the "world first" could finally help researchers prove mosquitoes are a carrier - something they have long hypothesised.

"It's always labelled as a mystery disease," he told news.com.au. "But we're hoping hope for control."

Amelia Grant knows what it's like to suffer from the insidious disease. The Geelong local spoke with news.com.au about "an open wound that refused to heal" last year.

 

An example of the ulcer that has spread around Victoria's peninsula region.
An example of the ulcer that has spread around Victoria's peninsula region.

 

She said it was red and itchy but did not realise that beneath the surface her flesh was being eaten away.

"It was 2006 when I got it, and there were only 50 cases in Victoria at that stage. Mine was a tiny little hole in my leg that didn't heal," she said.

"There was no pain, but I went to the doctor and luckily he diagnosed it straight away. I had a biopsy the next day that confirmed it, and it was cut out and stitched up."

Surgeons originally took a small chunk of skin from around the ulcer on Ms Grant's lower left leg. But six months later it was back.

"When it came back, it was in exactly the same spot. The next time they cut quite a big hole out of the front of my leg," she said.

A Buruli ulcer on the leg of patient who has contracted the disease. The Mornington Peninsula is in the grip of a disease outbreak. Picture : David Geraghty / The Australian.
A Buruli ulcer on the leg of patient who has contracted the disease. The Mornington Peninsula is in the grip of a disease outbreak. Picture : David Geraghty / The Australian.

Her story is increasingly familiar, but Prof Stinear says those living in the area should not be too worried.

Instead, they should be vigilant. If they get a small red mark, or what looks like a mosquito bite, and it doesn't heal on its own, they should see a doctor.

A test can be conducted to determine if it's Buruli ulcer and medication can treat it.

Infectious diseases specialist, Associate Professor Daniel O'Brien from Barwon Health, told news.com.au last year symptoms differed greatly between patients.

"For the majority of people it starts with a pimple on the limb. Most commonly it's on the legs or arms and it ulcerates in the middle. Typically, it's painless but some people can get a lump under the skin and the frightening version is very aggressive.

"In about 10 per cent of cases there's redness and swelling and pain, typically over a joint, that rapidly progresses."

Dr O'Brien said "nobody knows" why the Buruli ulcer is occurring in coastal Victoria when it is typically a tropical disease.

"What's it doing down there? We don't know. Therefore we don't know how to stop it going to other areas," he said.

 

 

For more information, visit the Beating Buruli website.

Strangely a normally tropical disease - the Buruli ulcer has been reported in the area. Picture: David Geraghty
Strangely a normally tropical disease - the Buruli ulcer has been reported in the area. Picture: David Geraghty

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