Buruli ulcer: a mysterious bacteria that eats human flesh

One day you wake up and discover a pimple on the surface of your skin. You do not give it more importance, because surely it is about a damn mosquito that has come to cloud your 'skin peace'. But weeks go by and what at first was a simple pimple turns into a wound that gradually gets bigger. What's more, it acquires an uninspiring blackish color.

This is what happened to a citizen of Melbourne, Australia, in the middle 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" in your heel, according to the case narrates the British newspaper 'BBC'. Doctors did several biopsies to give a diagnosis to this terrible wound. In the end, they discovered that it was a bacterial disease called Buruli ulcer which, if not treated 'ipso facto', pI would hate to end up crabbing the foot with no other option but to amputate.

"No matter how small or big the pimple or eczema is, it can eat up an entire limb"

It is not the first and only case. In the Australian state of Victoria, the number of people with Buruli ulcer has tripled in recent years: 65 patients were reported in 2014, while there were a total of 299 in 2019. So much so that there is a medical professional specialized in this strange and harmful disease called Daniel O'Brien, who runs a clinic in the port city of Geelong, seeing five to ten new patients a week.

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Buruli ulcer can rapidly destroy skin and soft tissues if not treated with a specific combination of antibiotics and steroids for weeks. The worst thing is that in certain cases the treatment can last for months to finally subside. "No matter how small or big the pimple or eczema is, there is no one who cannot be significantly affected by this disease," O'Brien says. "Actually, it can devour an entire 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 the 'BBC' has not recognized cases 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 high concentrations of this bacteria have been found in their feces. 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 opossums, although all this remains a mere hypothesis that has yet to be tested.

As it mainly affects poor African communities, no efforts have been made to investigate and analyze this disease

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 continent: in Uganda. "Because it mostly affects poor communities with limited healthcare, there hasn't been enough money to create time, effort and resources for an investigation," O'Brien says. Nobody knows how it has crossed so many countries and reached Australia.

One of the hypotheses that scientists use to explain the strong increase 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 Australia's natural surface, this species could have begun to inhabit the private gardens of residentsHence, they have a much closer contact with people, being able to increase the chances of contagion.

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