possum poo to blame for aussie flesh-eating cases
australia has seen rising cases of buruli ulcer since 2017, and while it is rare in north america, we are no stranger to flesh-eating disease.
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australia's recent rash of flesh-eating disease is believed to be spread by possums. getty
as australia marshals massive amounts of resources to contain the spread of covid-19, an equally insidious disease has been bubbling beneath the surface on the balmy beaches of melbourne.
buruli ulcer is a debilitating, necrotizing disease of the skin and soft tissue — a form of flesh-eating disease. although the source and mode of transmission remain an ongoing mystery, scientists believe possums play a role in the transfer of the disease to humans, according to the bbc. the nocturnal animals are also susceptible to infection and their feces are loaded with mycobacterium ulcerans, the bacteria that causes the infection.
as human development continues to threaten natural habitats and push possums closer to urban areas — such as the heavily populated melbourne — the spread of infection has become a rapidly worsening epidemic. scientists suspect mosquitos may also play a part in spreading the disease from possum to possum or possum to human but such transmission has yet to be documented and remains theoretical.
“we don’t know enough about it,” said daniel o’brien, the deputy director of the department of infectious diseases at barwon health in victoria. “there’s some really important scientific questions around where it leaves the environment, the other animal reservoirs and how humans actually acquire it. unless we get answers to these vital questions, we’re really going to struggle to control the disease.”
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what is known is that buruli ulcer, once acquired, initially presents as a small, red lump similar in appearance to an insect bite or pimple. if not treated immediately, the lump can enlarge within weeks and cause “severe destructive lesions of skin and soft tissue,” usually of the arms and legs, o’brien said. particularly aggressive ulcers can leave gaping holes in the flesh that require surgery or result in permanent disfigurement.
buruli ulcer is just one of a variety of diseases that feed on the flesh of unfortunate animals. necrotizing fasciitis — more common to north american headlines — may be an even more frightening version that can result when the bacteria vibrio vulnificus gets into an open wound. the disease, which affects close to 100 canadians annually, is also caused by undercooked shellfish, particularly oysters.
in 2017, there were close to 300 cases of buruli ulcer discovered in the australian state of victoria alone — up 51 per cent from the previous year. o’brien, an australian physician and buruli ulcer expert, said he sees five to 10 new patients weekly and immediately treats the condition with a combination of antibiotics and steroids that must be disbursed over weeks, if not months, to prevent rapid deterioration of tissue. “no matter how small the lesion, or how big it is, there’s nobody that’s not significantly affected by this disease,” he said. “it can really eat away at a whole limb. i wouldn’t say any treatment is ever easy. (the patients) all suffer to a significant degree.”
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fortunately for canadians, cases of buruli ulcer are exceedingly rare and infection generally requires travel to an endemic region. although the disease has been detected in at least 30 countries, most are found in the tropical and subtropical regions of africa, asia, australia and latin america. despite being discovered in uganda in 1897, the prevalence of buruli ulcer in poorer countries has resulted in it being classified as a “neglected disease” by the world health organization, hampering research efforts into potential treatments, even though thousands of cases are diagnosed worldwide annually. “there just hasn’t been the money to really put the time, effort and resources into the research,” o’brien said.
but with the help of new funding and collaborations with environmental researchers and other infectious disease experts, o’brien is hoping to uncover how buruli ulcer is transferred — the first step in taking a bite out of the disease. all he needs to do is navigate the pandemic currently making life miserable for most of the world.
“covid-19 is showing us that we can’t see diseases in isolation,” he said. “(coronavirus) may be respiratory and buruli bacterial, but they both come from nature, they both paste a warning of our interactions with nature, they’re both hugely damaging to human health.
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“learning the lessons of one is so important for the other.”
dave yasvinski is a writer with healthing.ca
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