Symptoms to look out for amid flesh-eating epidemic
IT’S “just a really ugly scar” for Amelia Grant now, but for a while it was an open wound that refused to heal.
For three long months the 38-year-old from Geelong in Victoria had what she describes as a “tiny little hole in my leg”. It was red and itchy on the surface but there was no cause for alarm, she thought.
She couldn’t have known that underneath the surface her flesh was being eaten away. Ms Grant had somehow picked up the mysterious flesh-eating Buruli ulcer during a trip to the Bellarine Peninsula in Victoria, an area health authorities this week declared a breeding ground for the disease where cases are at epidemic levels.
A startling report in the Medical Journal Of Australia on Monday demanded an “urgent scientific response”, citing a 400 per cent increase in confirmed infections in four years. This is what Ms Grant says people should look out for.
‘THERE WAS NO PAIN’
“It was 2006 when I got it and there were only 50 cases in Victoria at that stage. Mine was a tiny little hole in my leg that didn’t heal,” she told news.com.au.
“There was no pain but I went to the doctor and luckily he diagnosed it straight away. I had a biopsy the next day that confirmed it and it was cut out and stitched up.”
Surgeons originally took a small chunk of skin from around the ulcer on Ms Grant’s lower left leg. But six months later it was back.
“When it came back, it was in exactly the same spot. The next time they cut quite a big hole out of the front of my leg.”
She describes the hole left behind as “the size of a mandarin”. It would be four surgeries, including a skin graft, before the ulcer was gone for good.
Earlier this year, 12 years on, Ms Grant “freaked out” when a small red spot appeared. She raced to the doctor who told her it was a spider bite. Doctors say she would be very unlucky for the ulcer to return.
Ms Grant said the experience taught her that if something is not right, get it checked. She said the ulcer seemed harmless but could’ve done serious damage. She wants people who have visited the Bellarine Peninsula to keep an eye out for anything unusual, particularly on the limbs.
‘THE FRIGHTENING VERSION IS VERY AGGRESSIVE’
Infectious diseases specialist, associate professor Daniel O’Brien from Barwon Health, told news.com.au symptoms differ greatly between patients.
“For the majority of people it starts with a pimple on the limb. Most commonly it’s on the legs or arms and it ulcerates in the middle. Typically, it’s painless but some people can get a lump under the skin and the frightening version is very aggressive.
“In about 10 per cent of cases there’s redness and swelling and pain, typically over a joint, that rapidly progresses.”
Dr O’Brien said for some people it will get worse immediately while for others it will grow slowly, sometimes over a period of months and weeks. Naturally, the earlier it can be identified, the better.
“The quicker we get to it, the easier it is to treat,” he said. “It’ll heal quicker, there will be less damage to your body, you’ll need less antibiotics. From my experience, the key is often that the person is aware of it and asking health practitioners if it could be the Buruli ulcer.”
He said surgery is far less common today than it was 10 years ago. Patients are instead treated with antibiotics and the treatment is 99 per cent effective in curing the condition. But the drugs are powerful and about 20 per cent of people have a severe reaction, Dr O’Brien said.
‘THERE IS A MISSING LINK’
Dr O’Brien said “nobody knows” why the Buruli ulcer — also known as the Bairnsdale ulcer — is occurring in coastal Victoria when it is typically a tropical disease.
“What’s it doing down there? We don’t know. Therefore we don’t know how to stop it going to other areas.”
He and other experts have “educated theories” around how it is transmitted — including mosquito bites and soil getting into wounds — but no definitive answers.
“They’re our theories but none of that has ever been proven. The epidemic is increasing and you could argue that at this stage there probably is a missing link.”
Monday’s report declared that “as a community, we are facing a rapidly worsening epidemic of a severe disease without knowing how to prevent it”.
“We therefore need an urgent response based on robust scientific knowledge acquired by a thorough and exhaustive examination of the environment, local fauna, human behaviour and characteristics, and the interactions between them.
“It is only when we are armed with this critical knowledge that we can hope to halt the devastating impact of this disease through the design and implementation of effective public health interventions.
“The time to act is now, and we advocate for local, regional and national governments to urgently commit to funding the research needed to stop Buruli ulcer.”
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