A hypothesis refuted: Mycobacterium ulcerans is of recent evolution

Mycobacterium ulcerans infection is a disease of human beings that primarily affects subcutaneous fat, resulting in necrosis of the fat and secondary skin ulceration.1 Accompanying this ulceration is discharge of necrotic material together with vast numbers of mycobacteria into the environment. The...

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Bibliographic Details
Published in:The Lancet infectious diseases 2005-06, Vol.5 (6), p.327-328
Main Author: Hayman, John A
Format: Article
Language:English
Subjects:
Abrasion
Aerosols
Animals
Aquatic insects
Aquatic plants
Biological Evolution
Contamination
Detritus
Disease Reservoirs
Disease transmission
Ducks
Fermentation
Gangrene
Humans
Infections
Infectious diseases
Inoculation
Insecta - microbiology
Insects
Mycobacterium Infections, Nontuberculous - microbiology
Mycobacterium ulcerans
Mycobacterium ulcerans - genetics
Naucoridae
Necrosis
Organisms
Salivary glands
Salivary Glands - microbiology
Shallow water
Slime
Water Microbiology
Water pollution
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Summary:Mycobacterium ulcerans infection is a disease of human beings that primarily affects subcutaneous fat, resulting in necrosis of the fat and secondary skin ulceration.1 Accompanying this ulceration is discharge of necrotic material together with vast numbers of mycobacteria into the environment. The distribution of cases is consistent with the theory that infection occurs following the dissemination of the organism as a contaminated aerosol, generated by fermentation within decaying vegetable material and detritus at the bottom of shallow water.3 The organism is then inoculated through contaminated skin by minor abrasion or by abrasion from contaminated vegetation or other agent.4 Insect inoculation and insect transmission are not excluded. The finding of organism-specific DNA within suspected water sources and increased signal from mud and slime supports this theory.5 The isolation of M ulcerans from the salivary glands of aquatic insects (family Naucoridae), the experimental infection of these insects, and the transmission of disease to the tails of mice is of great interest.6 However, such isolation does not explain infection in Australian patients, the vast majority of whom have had no direct contact with contaminated water or any recollection of a bite from a relatively large insect.
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(05)70121-3