A terrifying disease stalks seaside Australia

To Rob Courtney, it looked like a sunburn. But after a few days, the redness and inflammation got worse. Soon, the skin on his right foot was split open, the wound oozing. His doctor sent him straight to the emergency room.

Then came the horrifying diagnosis: Courtney was infected with a species of flesh-eating bacteria.

In recent years, cases of the disease, known as Buruli ulcer, have exploded in the seaside area where Courtney, 80, lives in southeastern Australia.

As he would learn, it is a fearsome intruder. The ulcer left the flesh on his foot corroded and gangrenous. It devoured a skin graft. Eventually, doctors prescribed the same powerful antibiotics used to treat leprosy and tuberculosis. The drugs made him feel nauseated and fatigued, and turned his sweat and tears orange. He spent nearly 50 days in the hospital.

“It’s been a bit of a journey,” Courtney said recently as he lay on an examination table at his local clinic, where he has endured a daily wound dressing for several weeks. “I wouldn’t recommend it.”

Buruli ulcer has been reported in 33 countries, primarily in Africa, where a lack of access to health care can mean that cases go on for months, sometimes resulting in disfigurement and disability.

In Australia, where cases of the ulcer have been recorded since the 1940s, the recent increase in infections has brought new attention to the neglected disease. That, along with a growing global interest in infectious diseases, has raised hopes that scientists might finally have the resources to crack its code.

The area hit hardest in Australia is the Mornington Peninsula, in the state of Victoria. More than 180 cases per year have been reported in the state since 2016, peaking in 2018 at 340. In February, the disease crept further into the suburbs of Melbourne, a city of 5 million people.

No one knows exactly how the infection spreads or why it has flared on the Mornington Peninsula, an affluent region less than 50 miles from Melbourne where cafes line leafy boulevards and thousands of tourists visit each year.

Scientists think that Buruli ulcer and up to 75% of emerging diseases, including the coronavirus is zoonotic, meaning it jumps from animals to humans. They say zoonotic diseases are becoming more common in part because of human encroachment on wild environments.

As for the spike in cases in Victoria, the leading theory is that possums, a marsupial native to Australia, carry the bacteria, which are then transmitted to humans by mosquitoes that have come into contact with the animal’s feces.

The bacterium has long been present, but “what we’ve done is stumbled into it and maybe helped it to amplify and become the unwitting victims,” said Dr. Paul Johnson, a physician and professor of infectious diseases at Austin Health in Melbourne. “We’ve provided situations where it can expand rapidly and cause human disease.”

In recent years, as attention to the disease has increased funding for research, Johnson and others have been trying to figure out exactly how Buruli ulcer is transmitted. To test their theory, the scientists are working to reduce the number of mosquitoes on the Mornington Peninsula to see whether cases of Buruli ulcer drop as well.

On a Saturday in late February, Johnson and Tim Stinear, a professor of microbiology at the Doherty Institute at the University of Melbourne, led a troop of more than a dozen researchers — clad in yellow “Beating Buruli in Victoria” vests — as they set mosquito traps in the suburbs of the Mornington Peninsula.

The researchers have also been on the hunt for possum feces, which they say has given them a crucial map of hot spots where the bacteria are present. “Once you start looking for this stuff, you see it everywhere,” Stinear said as he knelt in a driveway, using a stick to scoop the scat into a sandwich bag. “Because it is everywhere.”