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Health Alert for General Practitioners - M. ulcerans (Bairnsdale/Buruli ulcer) - 1 September 2011
Since January 2011 the Department of Health has received 40 notifications of M. ulcerans (Bairnsdale/Buruli ulcer) compared with 21 for the same period last year and 32 for the full year in 2010.
Approximately 22 of these notifications have been in patients living on the Bellarine Peninsula, in particular the Point Lonsdale area and more recently Barwon Heads and Ocean Grove. However there are patients in the Melbourne metropolitan area who may have visited the Bellarine Peninsula or other coastal areas where M. ulcerans has been described, who are being diagnosed with the condition sometimes many months after their last visit.
Clinical features
BU is an uncommon infection which causes chronic, progressive skin ulcers, usually on exposed parts of the body such as the arms or legs. The infection begins as a painless or itchy pimple which breaks down to form an ulcer which can become extensive if untreated. Mature lesions have characteristic undermined edges. When identified and excised early there is a high cure rate with minimal scarring. If left untreated the ulcer can continue to enlarge, sometimes requiring extensive surgical excision and skin grafts.
Transmission and Prevention
Despite significant research into the infection, the mode of transmission remains unclear. It is thought that biting insects, particularly mosquitoes may play a role. The most important public health message continues to be protection against insect bites and seeking early diagnosis for any 'bite' or skin lesion that is slow to heal.
Is this atypical ulcer BU?
Think BU in any atypical ulcer in any patient who has visited (even for a short period) or is a resident of low lying coastal areas, particularly those known to have had cases of BU. These include:
- Bellarine Peninsula
- Frankston / Langwarrin
- Mornington Peninsula
- Westernport Bay
- East Gippsland
Test early with a dry swab sent for PCR to the Victorian Infectious Diseases Reference Laboratory (VIDRL) (either directly or via your usual pathology provider). Results can be available in 24 to 72 hours.
Call VIDRL on 9342 2600 for information on specimen collection.
Further information
For clinicians - members.ozemail.com.au/~groverjohnson/Mulcerans.htm
For consumers - www.betterhealth.vic.gov.au
Dr John Carnie
Chief Health Officer
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Health Alert for General Practitioners - M. ulcerans (Bairnsdale/Buruli ulcer) - 1 September 2011
