Buruli ulcer infections increasing rapidly, says WHO

The occurrence of the Buruli ulcer disease is rapidly increasing in several West African countries, including Benin, Burkina Faso, Cote d`Ivoire, Ghana, Guinea, Liberia, and Nigeria, a World Health Organisation spokesman told IRIN on Tuesday. Thousands of cases of the disease, which eats through skin, muscle and bone leaving victims disfigured, have been reported in recent years in West Africa, Dick Thompson said. More than 50 percent of the cases occur in children under 15 years of age. In Cote d`Ivoire 15,000 cases have been reported since 1978, affecting nearly 16 percent of people in some villages. In Ghana 6,000 cases were found in a survey in 1999, affecting 22 percent of people in some villages, while Benin has recorded 4,000 cases since 1989. "These cases were apparently an underestimate. Recently WHO has noted a dramatic increase in reported infections," Thompson said. "No one is sure where the bacterium live or how it enters the body. Somehow the bacteria pass through the skin, disable the alarms of the immune system, and release a corrosive toxin", WHO head of the Buruli Ulcer programme, Kingsley Asiedu said. Unlike other diseases, Asiedu said, the normal warnings of fever and pain rarely occur upon infection. The disease eats through the flesh for weeks or months until a crater (ulcer) appears. Drugs are generally ineffective and many patients undergo surgery and amputation. But in Ghana it costs US $780 to treat the disease, it recurred in 30 percent of surgery cases. Research into the disease has, however, been hampered by poor funding, Thompson said. On Monday, a small group of experts started a four-day meeting at WHO headquarters, Geneva, to discuss some recent research findings, he added. Caused by "Mycobacterium ulcerans" the disease is considered the third most common mycobacterial infection in human beings after tuberculosis and leprosy, and is endemic in at least 31 countries in Africa, the Western Pacific, Asia and South America. It was first detected in 1948 among farmers in Australia. But similar cases were described in 1897 in Uganda by Sir Albert Cook. It is named after an area of Uganda which was the site of many cases in the 1960s.