How buruli ulcer spreads in humans

Mosquito bites and puncture wounds are likely to transmit bacteria causing Buruli ulcer, a disfiguring infectious disease in humans.

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Buruli ulcer spreads via mosquito bites and puncture wounds, researchers have found. This infectious disease is spreading in areas near Melbourne, Australia. The University of Melbourne research team is led by Professor Tim Stinear from the Peter Doherty Institute for Infection and Immunity.

Buruli ulcer is caused by the bacterium Mycobacterium ulcerans. Possums are carriers, or reservoirs, of the bacteria in the Australian state of Victoria. But how the bacteria spread to humans was not known.

The researchers dipped the tails of mice in M. ulcerans and then punctured them with either mosquito bites or a needle. In both instances, the mice contracted Buruli ulcer (two of the 12 mice with mosquito bites, and 21 of the 24 with needle punctures). Mice whose tails were coated in M. ulcerans but not punctured did not develop the disease.

Buruli ulcer can cause skin ulcers and long-term disability in humans if not treated quickly. The number of cases in Victoria has risen from 66 in 2013 to around 300 in 2019. The disease is most common in Australia and sub-Saharan Africa but has also been found in at least 32 other countries.

Next steps

The team is working with local public health authorities in affected areas to stop the spread of the disease using established mosquito-control techniques. These include adding larvicides to stormwater drains and communicating with residents in high-risk areas about minimising regions of standing water on their property.

They are also working with research teams in Belgium, USA, Switzerland, France, Ivory Coast, Benin and Ghana to find other animal reservoirs of the bacterium in African countries.


NHMRC Project Grant (1049183) to Professor Tim Stinear and Professor Paul Johnson

End Buruli Ulcer Alliance grant (6032305815) to Dr John Wallace

Millersville University Faculty grant program to Dr John Wallace


Wallace JR et al (2017) Mycobacterium ulcerans low infectious dose and mechanical transmission support insect bites and puncturing injuries in the spread of Buruli ulcer. PLoS Neglected Tropical Diseases 11(4): p.e0005553. doi: 10.1371/journal.pntd.0005553

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First published on 10 March 2022.

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