Mycobacterium ulcerans in Possum Feces before Emergence in Humans, Australia

Area of Science:

• Environmental microbiology
• Infectious disease epidemiology
• One Health research

Background:

• Buruli ulcer, caused by Mycobacterium ulcerans, is an emerging infectious disease.
• The bacterium's environmental reservoirs and transmission routes remain incompletely understood.
• Urban emergence of Buruli ulcer presents unique public health challenges.

Purpose of the Study:

• To investigate the emergence of Buruli ulcer in Geelong, Victoria, Australia.
• To examine the temporal and spatial relationship between human cases and M. ulcerans detection in possum feces.
• To assess the utility of possum feces as an early warning indicator for Buruli ulcer risk.

Main Methods:

• Retrospective analysis of human Buruli ulcer case data in Geelong.
• Environmental sampling and molecular detection of M. ulcerans DNA in possum feces.
• Spatial and temporal correlation analysis between environmental and human case data.

Main Results:

• The study identified the emergence of Buruli ulcer in an urban setting.
• M. ulcerans DNA was detected in possum feces at sites preceding human cases.
• Detection of M. ulcerans DNA in possum feces occurred up to 39 months before the onset of human Buruli ulcer cases.

Conclusions:

• Possum feces can serve as a valuable environmental indicator for M. ulcerans.
• Early detection of M. ulcerans in possum feces provides a significant lead time for public health interventions.
• This finding supports the integration of wildlife surveillance into Buruli ulcer prevention strategies in affected regions.