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A large localized outbreak of Mycobacterium ulcerans infection on a temperate southern Australian island

Published online by Cambridge University Press:  01 December 1997

M. G. K. VEITCH
Affiliation:
National Centre for Epidemiology and Population Health, Australian National University, Canberra and Infectious Diseases Unit, Health and Community Services Victoria
P. D. R. JOHNSON
Affiliation:
Royal Children's Hospital, Parkville, Victoria, 3052; Infectious Diseases Physician, Monash Medical Centre, Clayton, Victoria, 3168; formerly Physician, Fairfield Hospital
P. E. FLOOD
Affiliation:
Cowes Medical Centre, Cowes, Victoria, 3922; Medical Officer of Health, Phillip Island
D. E. LESLIE
Affiliation:
Mycobacterium Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Fairfield, Victoria, 3078
A. C. STREET
Affiliation:
Royal Melbourne Hospital, Parkville, Victoria, 3050; formerly Physician, Fairfield Hospital
J. A. HAYMAN
Affiliation:
Box Hill Hospital, Box Hill, Victoria, 3128
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Abstract

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Mycobacterium ulcerans, the organism which causes Buruli or Bairnsdale ulcer, has never been isolated in culture from an environmental sample. Most foci of infection are in tropical regions. The authors describe the first 29 cases of M. ulcerans infection from a new focus on an island in temperate southern Australia, 1992–5. Cases were mostly elderly, had predominantly distal limb lesions and were clustered in a small region in the eastern half of the main town on the island. The authors suspected that an irrigation system which lay in the midst of the cluster was a source of infection. Limitation of irrigation was associated with a dramatic reduction in the number of new cases. These findings support the hypothesis that M. ulcerans has an aquatic reservoir and that persons may be infected directly or indirectly by mycobacteria disseminated locally by spray irrigation.

Type
Research Article
Copyright
© 1997 Cambridge University Press