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Bartley B, O'Brien D. Buruli ulcer - A neglected tropical disease in the Barwon region of Victoria, Australia: An emerging public health threat with local and national ramifications. Emerg Med Australas 2023; 35:697-701. [PMID: 37454363 DOI: 10.1111/1742-6723.14235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/18/2023] [Indexed: 07/18/2023]
Abstract
Mycobacterium ulcerans (MU) is known to be endemic in heavily touristed coastal regions of Victoria and is the cause of Buruli ulcer (BU) disease. The incidence, severity and geographic spread of MU infection/BU disease is increasing, including metropolitan Victorian suburbs. While the specifics of disease transmission and effective prevention strategies remain uncertain, severe complications can be mitigated by health systems that provide vigilant population surveillance to underpin early recognition, early specialist involvement and definitive treatment for the individual. Current theories regarding disease transmission and 'best practice' (or best guess) prevention and mitigation measures are presented herein. Opportunities to improve the health system response to this emerging public health threat are identified. It is incumbent upon all healthcare providers, including ED clinicians, to contribute by familiarising themselves with the established and emerging areas of endemicity of MU infection and the array of BU clinical presentations.
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Affiliation(s)
- Bruce Bartley
- Emergency Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Daniel O'Brien
- Department of Infectious Diseases, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
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Muhi S, Osowicki J, O'Brien D, Johnson PDR, Pidot S, Doerflinger M, Marshall JL, Pellegrini M, McCarthy J, Stinear TP. A human model of Buruli ulcer: The case for controlled human infection and considerations for selecting a Mycobacterium ulcerans challenge strain. PLoS Negl Trop Dis 2023; 17:e0011394. [PMID: 37384606 DOI: 10.1371/journal.pntd.0011394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
Critical knowledge gaps regarding infection with Mycobacterium ulcerans, the cause of Buruli ulcer (BU), have impeded development of new therapeutic approaches and vaccines for prevention of this neglected tropical disease. Here, we review the current understanding of host-pathogen interactions and correlates of immune protection to explore the case for establishing a controlled human infection model of M. ulcerans infection. We also summarise the overarching safety considerations and present a rationale for selecting a suitable challenge strain.
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Affiliation(s)
- Stephen Muhi
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Joshua Osowicki
- Tropical Diseases Research Group, Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
- Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Daniel O'Brien
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
| | - Paul D R Johnson
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Heidelberg, Victoria, Australia
| | - Sacha Pidot
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marcel Doerflinger
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Julia L Marshall
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marc Pellegrini
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - James McCarthy
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Timothy P Stinear
- Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
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Mahony M, Hung TY, Cox V, Sufyan W, Wallis P, Nizzero D, Francis J, Yan J. Complicated Mycobacterium ulcerans infection in a child in the Northern Territory. J Paediatr Child Health 2023; 59:392-394. [PMID: 36422163 DOI: 10.1111/jpc.16288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Michelle Mahony
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Te-Yu Hung
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Victoria Cox
- Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Global Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Wajiha Sufyan
- Anatomical Pathology, Territory Pathology, Darwin, Northern Territory, Australia
| | - Peter Wallis
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Danielle Nizzero
- Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Joshua Francis
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Global Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Jennifer Yan
- Department of Paediatrics, Division of Women, Child and Youth Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Global Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
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