Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic, debilitating, necrotizing disease of the skin and soft tissue. Buruli ulcer is an emerging infectious disease and is the third most common mycobacterial disease of the immunocompetent host, after tuberculosis and leprosy.
Buruli ulcer is caused by subcutaneous infection with a bacteria called Mycobacterium ulcerans.
It is a “flesh-eating” infection that starts as a painless lump, but can result in extremely large and debilitating ulcers
We do not know how many cases of Buruli ulcer there are in the world each year, the WHO reports around 6000 cases/year but many more cases are likely unreported
Despite their large size, the ulcers are usually painless and this is one of the reasons why people do not seek treatment until the late stages of the disease
The bacteria makes an oily toxin (mycolactone) that can migrate through the skin away from the bacteria, and it is this toxin that causes the pathology
Buruli ulcer is most common in resource-poor, and frequently inaccessible, rural communities of West African countries such as Ghana, Cote d’Ivoire and Benin. Other skin diseases like Leishmania, Yaws and Leprosy are also found, and they are hard to discriminate from one another without access to molecular diagnostic laboratories.
The disease can be treated with a long course of strong antibiotics, but the major issue remaining is that of wound healing – which can sometimes take over a year
The route of transmission is not known. While it is known to be acquired from the environment, rather than spread from person to person, it is not known how this happens. A barrier to this is identifying the causative bacteria in the environmental samples
In a unique collaboration between artists and scientists, we are developing improved diagnostic information based on medical illustrations which are better than photographs
We are investigating the role of blood clotting pathways in the progression of the diseases, and working with mathematicians to model how treating this aspect could improve wound healing
We are developing improved work flows for the identification of Mycobacteria using novel next generation sequencing approaches
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