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Underreporting is considered likely, as BU mostly affects populations in remote areas with limited access to the formal health sector. Although transmission pathways of M. ulcerans are still unclear, infection foci are closely associated with wetlands. This is the third most common disease after tuberculosis and leprosy.
Although, it is not known how people get Buruli ulcer.One possibility is that the disease is passed to humans from some insects that are found in water. While no proven link exists between human and animal infection, some animals can get the disease.For example, laboratory tests from Victoria, Australia, confirmed the disease in several animals including horses, dogs, Alpacas, Koalas, Possum, etc.
The symptoms of Buruli ulcer include: swelling of the skin, destroyed skin and soft tissue, and one or more slow growing, generally painless ulcers. People who are sick should see a doctor and get antibiotics (medicine that can help stop the disease). If these antibiotics are not given soon after getting sick, the disease can sometimes lead to:Deformity, Functional disability (such as limited joint movement), Bone infection, Secondary bacterial infection of skin ulcer lesions.
Buruli ulcer is found in at least 33 countries with tropical, subtropical, and temperate climates.In 15 of these 33 countries, between 5,000 and 6,000 cases are reported every year. Overall, most cases occur in rural communities in sub-Saharan Africa. Nearly half of those affected in Africa are children under 15 years of age.
Prior to 2004, excision was the treatment of choice for Buruli ulcers. Most patients required multiple staged surgeries and extensive skin grafts, which resulted in prolonged hospitalizations, averaging around three months. Recurrence rates after surgery alone were 16-28 per cent. With the use of antibiotics, 40 per cent of patients do not require surgery.
In conjunction with antibiotics, surgery is used to remove devitalised tissue, cover open wounds with skin grafts, and correct or minimise deformities.While traditionally Buruli ulcers are thought to be painless as a result of the neurotoxic effects of mycolactone, many patients experience pain during wound care, which must be addressed.
Currently, the only dressing used for wound care is gauze, which results in pain and bleeding when removed. More research needs to be performed to determine the best dressings to be used for these patients. Additionally, the availability of clean water and good hygiene are important for the management of Buruli ulcers and prevention of secondary infections.
Suggestions to reduce the risk of infection include: Reduce mosquito breeding sites around houses and other accommodation by reducing areas where water can pool (including pot plant containers, buckets, open tins or cans, discarded tyres, and other untreated, freshwater pools).
Mosquito proof your home by securing insect screens on accommodation.
Avoid mosquito bites by using personal insect repellents containing diethyltoluamide (DEET) or picaridin