Did you know that the Buruli ulcer / Bairnsdale ulcer also known as the Searls ulcer, or Daintree ulcer is on the increase in Australia? In the past it has been found predominantly in Nigeria, Mali and other west African countries. ‘Australia is the only developed country with significant Bairnsdale ulcer outbreaks.’ ‘In Australia the number of cases has almost doubled in the past three years. In 2015, there were 106 cases recorded in Victoria, up from the 65 in 2013. There have already been 45 cases recorded this year in Victoria alone.’ There has also been a number of people infected in far-north Queensland near Mossman and on the Capricorn Coast of Queensland near Yeppoon. The tropical north coast near Darwin has also suffered an outbreak.
I was surprised to learn this week of its occurrence in Melbourne Suburbs. It is caused by Mycobacterium ulcerans. ‘ The early stage of the infection is characterised by a painless nodule or area of swelling. This nodule can turn into an ulcer which may be larger inside than at the surface of the skin, and can be surrounded by swelling. As the disease worsens, bone can be infected.
Nurses are familiar with Arterial , Venous and Mixed Ulcers – but how many of us are familiar with the Buruli Ulcer? Its important that Nurses are aware that this condition often presents with the patient sharing a history that involves a simple mosquito bite that over a number of weeks or months evolves into an ulcer that just won’t heal. The AMA ha updated the 2007 guidelines for the management of the Ulcers. Antibiotics are now the mainstream treatment with the antibiotic regime needing to be adhered to for a minimum of 8 weeks, which may be extended to 12 weeks dependent upon the patients history. Surgery does remain an option for those patients that meet specific criteria. It was interesting to know that often the ulcers won’t be completely healed at the time of cessation of the antibiotic regime.
The online article was very interesting and you can read it in full here>>Here are some key points from the article which Austin Health infectious diseases physician and medical researcher Professor Paul Johnson identified:
- It is believed to be spread by either mosquitoes, or through possums after they have been bitten by the insect.
- It starts out looking like any normal mosquito bite but months later a volcano-like wound will develop and start eating through the flesh.
- It’s easily curable if caught early but, if not, it can lead to further complications. Some sufferers need surgery, some endure extreme scarring and others even need to have limbs amputated.
- In rare cases the ulcer could also cause gangrene, the death and decomposition of body tissue.
- The ulcer often erupts on the elbow, back, calf or ankle about four months after a person has been bitten.
- The incubation process is slow, and it’s likely transmitted while people are in tropical and coastal climates.
The incidence of these ulcers can be reduced by the wearing of appropriate, protective clothing when gardening and undertaking recreational activities in areas where there have been cases of the Ulcers. Cuts and abrasions should be cleaned promptly and exposed skin contaminated by suspect soil or water should be washed following outdoor activities. Insect repellent should also be used.
There is a great read quiz on the Nurses for Nurses Network which covers the latest tretment options. The Nurses for Nurses Network provides good information and CPD on an array of nursing topics including wound care in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember the Nurses for Nurses Network was created by Australian Nurses for Nurses ! www.nursesfornurses.com.au
News.com.au http://bit.ly/2b77ZLn ( accessed 21.08.16)
Centre for Disease Control http://www.cdc.gov/buruli-ulcer/transmission.html ( accessed 21.08.16)
The Medical Journal of Australia https://www.mja.com.au/journal/2014/200/5/treatment-and-prevention-mycobacterium-ulcerans-infection-buruli-ulcer-australia ( accessed 21.08.16)