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Novel tool predicts Buruli ulcer outbreaks in Victoria

Novel tool predicts Buruli ulcer outbreaks in Victoria
Geographical surveillance of M. ulcerans in the Mornington Peninsula during the southern hemisphere's summer. he distribution of points where possum excreta was sampled along a 200 m grid pattern is presented alongside with IS2404 molecular screening results. The pink to purple color gradient visualizes inferred mycobacterial loads in analyzed excreta as estimated from IS2404 cycle thresholds. The dashed red circles represent significant (p<0.005) non-random clustering of IS2404 positive possum excreta identified with spatial scan statistics. All Buruli ulcer (BU) patients notified to the Department of Health (DH) with an inferred exposure time that overlapped with the excreta survey organized during summer are tabulated here by mesh block. A gradient is used to illustrate BU case counts per mesh block. The dashed blue circles represent geographical areas with higher rates of BU than would be expected if the risk of contracting BU was evenly distributed across the Peninsula. Credit: eLife (2023). DOI: 10.7554/eLife.84983

Researchers have developed a surveillance system capable of detecting elevated risks of Buruli ulcer outbreaks in Victoria thanks to possum 'poo'—a breakthrough in the fight against the disease.

Once considered an exotic bacterial infection, Buruli ulcer has become an important problem in Victoria, with the state now considered one of the most endemic areas for the disease globally.

Over the past five years, "Beating Buruli ulcer in Victoria", a world-first, collaborative research project led by University of Melbourne Professor Tim Stinear, Director of the WHO Collaborating Centre for Mycobacterium ulcerans at the Peter Doherty Institute for Infection and Immunity (Doherty Institute), has made significant progress in understanding how the disease is transmitted and what can be done to prevent infections from the flesh-eating bacteria.

In addition to confirming the role Australian native possums play in human outbreaks of Buruli ulcer, a recent study published in eLife described a ground-breaking surveillance tool created by the "Beating Buruli ulcer in Victoria" research team with the potential to control the disease.

Comparing data from possum 'poo' analysis to epidemiological data over time, researchers identified a significant spatial correlation between clusters of M. ulcerans positive possum excreta and clusters of human Buruli ulcer cases.

"Our data showed that outbreaks of Buruli ulcer coincided with a high number of possums carrying the bacteria. While it is something we've been suspecting for a while, this finding categorically confirms the important role of Australian native possums in the transmission of the bacterium to humans," Professor Stinear said.

Following this significant finding and using the possum 'poo' data, the team developed the first-ever computer modeling program capable of predicting locations and times of increased Buruli ulcer transmission risk in Victoria.

Professor Nick Golding is an infectious disease modeler at Curtin University, with a focus on mathematical and statistical modeling, ecology, and public health.

"We developed a that uses the GPS coordinates of where we have detected the M. ulcerans bacteria in possum excreta, and identifies the households that are most likely to be at risk from Buruli ulcer in the coming months," Professor Golding explained.

The represents major progress towards the control and elimination of Buruli ulcer in southeast Australia.

"This sophisticated early warning system could play a significant role in preventing cases of Buruli ulcer in Victoria by alerting the public and local healthcare providers to the increased risk of infection," Professor Stinear said.

"The Victorian Department of Health is a key collaborator in this project and, together, we are discussing how they can use this program to inform the design and delivery of targeted public health interventions to prevent human cases."

More information: Koen Vandelannoote et al, Statistical modeling based on structured surveys of Australian native possum excreta harboring Mycobacterium ulcerans predicts Buruli ulcer occurrence in humans, eLife (2023). DOI: 10.7554/eLife.84983

Journal information: eLife

Provided by The Peter Doherty Institute for Infection and Immunity
Citation: Novel tool predicts Buruli ulcer outbreaks in Victoria (2023, May 23) retrieved 8 June 2023 from
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