Southern NSW Local Health District is urging the community to be alert to symptoms of the skin infection Buruli ulcer, and to avoid mosquito bites, after a Batemans Bay resident was diagnosed with the infection last month for the first known time in NSW.
SNSWLHD’s Acting Director of Public Health, April Roberts-Witteveen, said Buruli ulcer is not spread from person-to-person and is caused by the bacterium Mycobacterium ulcerans. The infection is most likely spread by mosquitoes.
Ms Roberts-Witteveen said the recent local infection in a Batemans Bay resident prompted further investigations by public health officials who subsequently found evidence of two other historical confirmed cases of the Buruli ulcer in the area since 2021.
"All three people are understood to have been infected locally and are the only local transmissions observed in New South Wales to date," Ms Roberts-Witteveen said.
Buruli ulcer has been routinely reported in parts of Queensland, Northern Territory, and multiple areas in Victoria where the number of varies widely from year to year, increasing to between 200-340 cases per year since 2017.
"Previous cases of Buruli ulcer in NSW have been diagnosed in people who had travelled to affected areas of Victoria or Queensland, so finding the infection in NSW in people who have not travelled is unusual," Ms Roberts-Witteveen said.
"While the precise transmission method for Buruli ulcer is not fully understood, there is increasing evidence from other parts of Australia that mosquitoes and possums likely play a key role."
Ms Roberts-Witteveen said NSW Health is assessing the role of possums and mosquitoes as part of the investigation into transmission in the area.
NSW Health is also communicating with local health care providers to ensure they are aware of the possibility of infections in people who have not travelled.
"Because mosquitoes likely play an important role in the transmission of Buruli ulcer to humans, we remind people of the steps they can take to prevent mosquito bites as the temperatures increase over coming months," she said.
"Residents can prevent mosquito breeding by removing items around their home that might collect water, such as old tyres or empty pots. Drainage issues should be addressed so that water does not
become stagnant. Ensure coverings for windows and doors have insect screens with no holes or gaps in them."
Buruli ulcer typically starts as a painless nodule or papule, often mistaken for an insect bite, and eventually progresses into an ulcer which can last many months with undermined edges (where the infection is mostly below the surface of the skin, in the subcutaneous tissue).)
Patients typically report symptoms around four to five months after being bitten by a mosquito. However, in some cases symptoms may not appear for up to nine months.
Early recognition and treatment are important. Effective treatment consists of eight weeks of special antibiotic therapy. Anyone who is concerned about a non-healing skin ulcer should see their General Practitioner.