Buruli ulcer – how to reduce your risk

What is Buruli Ulcer?

The Buruli ulcer is a skin disease caused by the bacterium Mycobacterium ulcerans. The toxins made by the bacteria destroy skin cells, small blood vessels and fat under the skin, which leads to ulceration.

These bacteria are found in the environment, but it is not known exactly how humans become infected. In Victoria, there is increasing evidence that mosquitoes and possums have a role in transmitting the infection to humans.

Buruli ulcer is not known to be transmitted from person-to-person, however, if you’re living with someone who has Buruli ulcer, it is recommended you self-monitor for any non-healing skin lesions.

It is important to remember that the risk of infection is low – even in areas of the state where the infection is endemic (constantly present in the community).

Symptoms of Buruli ulcer

• A spot that looks like a mosquito or spider bite forms on the skin (most commonly on the limbs).
• The spot grows bigger over days or weeks.
• The spot may form a scab.
• The scab disintegrates into an ulcer.
• The ulcer continues to enlarge.
• This ulcer is usually painless and there is generally no fever or other signs of infection.
• The infection may sometimes present with no ulceration but with localised pain, swelling and fever, raised lumps, or thickened or raised flat areas of skin.

Buruli ulcer is usually diagnosed by a doctor, based on your medical history, travel history, a physical examination, or swabs or biopsy taken from the ulcer.

Early recognition and diagnosis is important to prevent skin and tissue loss. See your GP if you have a non-healing skin lesion.

Reduce your risk

• Mosquito-proof your home by securing insect screens.
• Avoid mosquito bites by using personal insect repellents containing diethyltoluamide (DEET) or picaridin.
• Cover up by wearing long, loose-fitting, light-coloured clothing.
• Avoid mosquito-prone areas, especially at dusk and dawn.
• Wear gardening gloves, long sleeved shirts and trousers when gardening.
• Wear insect repellent on any exposed skin.
• Protect cuts and abrasions with a dressing.
• Promptly wash any new scratches or cuts you receive with soap and apply a topical antiseptic and dressing.
• Exposed skin contaminated by soil or water should be washed following outdoor activities.

Treatment

Most Buruli ulcers require treatment with a course of oral antibiotics. Surgery is sometimes used in combination with antibiotic therapy if required to promote healing.

If you’re living with diabetes, you’re likely already keeping an eye on your skin. Cases of Buruli ulcer have been reported in locations across the state, however they remain extremely rare.

Chat with your GP if you’re concerned about a skin lesion that’s taking longer than usual to heal.