Its effects were better known in Africa, but cases have multiplied in recent years exponentially in Australia. What’s the cause of this strange neglected disease?
One day you get up and discover a pimple on the surface of your skin. You don’t give it any more importance, because it’s probably a mosquito that’s come to muddy your ‘skin peace’. But weeks pass and what was at first a simple pimple becomes a wound that gradually gets bigger. In addition, it acquires a blackish color that is not hopeful.
This is what happened to a citizen of Melbourne, Australia, in the midst of a pandemic. It was April 2020 and the patient arrived at the hospital with a kind of “black hole the size of a ping-pong ball” on his heel. Doctors did several biopsies to diagnose such a terrible wound. In the end, they discovered that it was a bacterial disease called Buruli ulcer which, by the fact itself, could end up crabbing the foot without leaving any choice but to amputate.
It’s not the first and only case. In Australia’s Victoria state, the number of people with Buruli ulcer has tripled in recent years: in 2014 65 patients were reported, while in 2019 there were a total of 299. So much so that there is a medical professional specializing in this strange and harmful disease named Daniel O’Brien, who runs a clinic in the port city of Geelong, seeing between five and ten new patients a week.
Buruli ulcer can quickly destroy skin and soft tissues if left untreated with a specific combination of antibiotics and steroids for weeks. The worst part is that in some cases the treatment may go on for months to finally subside.
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“No matter how small or large the pimple or eczema is, there is no one who cannot be significantly affected by this disease,” O’Brien says. “Actually, it can eat a whole limb.”
For this reason, the doctor usually prescribes a type of medicine called rifampicin, a very powerful antibiotic that ‘a priori’ is used to treat much more serious diseases such as tuberculosis or leprosy. Depending on the severity of the ulcer, a few doses of steroids are also administered, without clearing the option of resorting to surgery. Either way, O’Brien is clear: “No treatment is easy, all patients tend to suffer to a significant degree.”
All eyes on the possums
A pause to take a breath: fortunately, Australia is very far from our borders and there is such case has been reported yet outside this oceanic country. What is its origin and why are there only patients at this point on the earth map? Scientists suspect it is due to the high population of possums on the remote island, as large concentrations of this bacteria have been found in their faeces. As much as the coronavirus is associated with bats or pangolins, Buruli ulcer disease is assigned to this marsupial mammal. It is assumed that mosquitoes are the insect that makes the connection between humans and possums, although all this remains a mere hypothesis that has yet to be verified.
The World Health Organization qualifies Buruli ulcer as a ” neglected disease ” as it does not receive much attention and also is not known much about it. The first time a case was reported was in 1987, far away from the Australian mainland – in Uganda.
“Because it mostly affects poor communities with limited health care, there has not been enough money to create time, effort and resources for an investigation,” O’Brien says. No one knows how it has crossed so many countries and reached Australia.
One of the hypotheses that scientists use to explain the strong rebound in cases in recent years is the change in the natural habitat of possums as a result of urban expansion carried out by humans. Having deforested a large part of the natural surface of Australia, this species could have begun to inhabit the private gardens of residents, hence they have much closer contact with people, and may increase the chances of contagion.