A flesh-eating disease common in third world countries is infecting parts of Victoria at increasingly epidemic rates and doctors have no idea why. 
 
 Mycobacterium Ulcerans, an infection which eats away at the limbs like gangrene, has more than doubled in Victoria in the last year with 240 new cases. In the past few months nine people have been diagnosed with it each week. 
 
 The disease, also known as the Bairnsdale Ulcer, is strangely migrating from the Bellarine peninsula to the Mornington peninsula, which has become a hot-spot for the disease. 
 
 WARNING: Graphic images below. 
 
 Ella Crofts, an active and healthy 13-year-old from Tyabb, was struck down with Mycobacterium Ulcerans in April and is still trying to recover from the disease that turned her knee into a festering sore the size of her palm. 
 
 Her mother Lucy Burns, who is also a GP, told Nine.com.au that when her daughter first complained of a sore knee there were no visible signs of the disease. 
 
 “There was nothing to see, then it started to look a little swollen around the knee but nothing too much to worry about,” Dr Burns said. 
 
 “A couple of days later it started to get the smallest of sores like a scab or a carpet burn and then a bit of redness around it.” 
 
 Ella’s parents took her to a local GP, who put her on antibiotics, but the wound continued to get worse. 
 
 The ulcer is not normally painful, but in Ella’s case it was excruciatingly so, Dr Burns said. 
 
 “She was on really high strong painkillers and then the pain settled.” 
 
 “Initially, she would get around on crutches or limp.” 
 
 Ella's knee pictured before surgery and one month ago. 
 
 Swab tests for bacteria came back negative, but Ella’s father – who also has a medical background – was concerned about the possibility of Mycobacterium Ulcerans, and pushed for a biopsy which eventually confirmed the disease. 
 
 Ella has since endured three operations to clean out the dead tissue around her knee and is still walking with a limp. 
 
 The wound is healing, but very slowly, Dr Burns said. 
 
 “It’s still not looking that great. We call it the zombie leg,” she said. 
 
 The schoolgirl this week started an online petition calling for Health Minister Greg Hunt – who is also her local MP – to provide more funding for research into the disease and has already collected more than 6700 signatures. 
 
 Ella’s doctor, Daniel O’Brien, who is one of the world’s leading infectious disease experts and operates out of the Royal Melbourne and Geelong hospitals, told Nine.com.au that Mycobacterium Ulcerans was an epidemic that needed to be addressed urgently. 
 
 “Bottom line is we had 70 percent more cases last year than we have ever had and we are more than double this year already on last year,” he said. 
 
 Just as worryingly, the number of severe cases of the disease, such as Ella’s, had doubled in the last five years, he said. 
 
 “We don’t know why. I can only suspect that the organism has adapted or mutated or evolved so it is becoming more virulent and causing more severe cases,” he said. 
 
 The first case of Mycobacterium Ulcerans – which is found in mostly African countries such as Uganda, Nigeria and Liberia - was spotted at Bairnsdale in East Gippsland in 1948 and then moved westward across the state. 
 
 The disease popped up in Phillip Island in the 90s and in the early 2000s it appeared in the Bellarine Peninsula. 
 
 Dr O’Brien said it was still a puzzle as to why the disease was migrating around the state and not much was even known about how it was spread. 
 
 “There are theories about transmission via mosquitos, theories about it being in the soil and getting through wounds, theories about whether some animals are involved in that we know that some possums can be affected by it. 
 
 “But we don’t actually know where it lives, why it’s there and how it gets spread to humans. How can we possibility halt an epidemic when we don’t have that basic information?” 
 
 Dr O’Brien said funding was desperately needed for scientists to conduct more research into the disease. 
 
 “I’m at the forefront as a clinician trying to treat patients and getting more and more overwhelmed but also distressed at the fact that we are doing nothing to try and prevent people getting it in the first place,” he said. 
 
 “For me this is an urgent health problem that our community needs addressed and I think our government should be putting significant amounts of money into trying to stop it and that means research.” 
 
 © Nine Digital Pty Ltd 2018 ||||| In the last year, cases of a ghastly but mysterious flesh-eating bacterial infection have more than doubled in Victoria, Australia, raising alarm among health experts. 
 
 There were 239 cases of the flesh-eating infections in the past 12 months, according to figures (PDF) released this week by health authorities. In 2016, there were only 102 reported cases, while 2015 and 2014 tallied just 58 and 47. And the rate of new infections is currently skyrocketing: in the past few months, case counts hit nine per week, according to Australia’s Nine News. The number of severe cases has also doubled. 
 
 While the rises alone are enough to worry health experts, the fact that virtually nothing is known about the cause of the infection has some dismayed. 
 
 “I’m at the forefront as a clinician trying to treat patients and getting more and more overwhelmed but also distressed at the fact that we are doing nothing to try and prevent people getting it in the first place,” Dr. Daniel O’Brien, of Royal Melbourne and Geelong hospitals, told Nine News. 
 
 Baffling bacteria 
 
 The infections are caused by Mycobacterium ulcerans, a slow-growing bacterium that causes gaping, palm-sized ulcers. Sometimes called Buruli ulcers, the lesions seem to dissolve skin and gnaw away at tissue. The bacteria are known to lurk around Victoria, but experts don’t know where it lives or how it spreads. 
 
 “There are theories about transmission via mosquitos, theories about it being in the soil and getting through wounds, theories about whether some animals are involved, in that we know that some possums can be affected by it,” O’Brien said. “But we don’t actually know where it lives, why it’s there, and how it gets spread to humans. How can we possibility halt an epidemic when we don’t have that basic information?” 
 
 The bacterium was first identified in Australia in 1948, but the ulcers get their name from Buruli county (now called Nakasongola) in Uganda, where researchers reported large numbers of ulcers in the 1960s. 
 
 It’s now known to skulk in at least 33 countries, and the World Health Organization considers it “largely a problem of the poor in remote rural areas (PDF).” It causes a few thousand cases worldwide each year, most of which are in children under the age of 15. 
 
 Antibiotics are usually effective at treating the lesions. But, early treatment is critical to reducing skin loss and tissue damage. Victims often need surgery to clean out dead flesh and repair wounds. 
 
 Zombie limbs 
 
 There are currently no prevention strategies or vaccines. Despite decades of knowing about the bacteria, researchers are still stumped by them. A study published just this April added weight to the idea that the bacteria are somehow linked to disturbed water sources, such as those with flooding or deforestation. 
 
 A study out last month looked at where the ulcers show up on people. The study of 579 patients found that they tend to cluster on arms and legs. The researchers, co-led by O’Brien, concluded: 
 
 “We propose that targeting behavior by biting insects rather than direct contact with a contaminated environment best explains the lesion distribution we observed.” 
 
 One likely source of confusion for researchers is the slow-growing nature of M. ulcerans. It’s unclear how quickly symptoms show up after a person is infected, but authorities estimate that it’s somewhere in the range of four weeks to nine months. Such a large window can make it difficult to pinpoint when or where an exposure occurred, let alone how. 
 
 “For me this is an urgent health problem that our community needs addressed,” O’Brien said. “I think our government should be putting significant amounts of money into trying to stop it and that means research.” 
 
 This week, a 13-year-old girl from Tyabb, Victoria, started an online petition to urge Health Minister Greg Hunt to provide more research funding for the disease. The girl was stricken with a Buruli ulcer on her knee in April and is still recovering. She needed three surgeries to clear out rotting flesh. (Here's a picture of her ulcer, but warning, it's gruesome.) 
 
 “It’s still not looking that great,” she said. “We call it the zombie leg.” ||||| Flesh-eating bacteria cases on Mornington Peninsula prompt calls for research on Mycobacterium ulcerans 
 
 Updated 
 
 When builder Anthony Fleming noticed a small red mark on his shin, he thought it was nothing more than an insect or spider bite. 
 
 Key points: Mr Fleming was infected with Mycobaterium ulcerans, a type of flesh-eating bacteria 
 
 He will have to continue to take antibiotics for another 12 weeks 
 
 There has been a three-fold increase in the number of cases since 2014 
 
 Little did he know he had been infected by flesh-eating bacteria, and within three months his red dot had become a raw and weeping wound the size of a 10-cent coin. 
 
 "It was getting nastier every time I looked at it," Mr Fleming, from Langwarrin on the fringe of the Mornington Peninsula, said. 
 
 "It went for about a month, two months and I started getting concerned. My local GP put me on antibiotics. They didn't work." 
 
 WARNING: This story contains graphic images. 
 
 Mr Fleming was eventually referred to a specialist, who identified he was infected by Mycobacterium ulcerans. 
 
 The bacteria causes severe pain and inflammation, and eats away at body tissue. 
 
 It is found mostly in African countries such as Uganda, Nigeria and Liberia. 
 
 "I'm just glad I had the specialists at my availability that were able to point me in the right direction and get a result quickly," Mr Fleming said. 
 
 "I was glad it happened to me and not one of my three kids." 
 
 Mr Fleming has been on his latest antibiotics course for eight weeks and will need to continue taking the drugs for another 12. 
 
 'We're in the middle of an epidemic' 
 
 The infection is normally associated with developing countries, but Victoria has experienced a three-fold increase in the number of cases since 2014. 
 
 There have been 159 cases in the state so far this year. In 2014, there were 47 cases. 
 
 "It's becoming increasingly common," said Professor Tim Stinear, a microbiologist from the Doherty Institute infection research centre. 
 
 "We're in the middle of an epidemic." 
 
 Authorities said the disease was known to reside in possums and it is thought to spread to humans through mosquitos. 
 
 They are now examining possum faeces collected on the Mornington Peninsula to better understand how the disease spreads. 
 
 The disease is colloquially known as the "Bairnsdale Ulcer" because of an outbreak in the Gippsland town several years ago, although now it is more commonly found on the Mornington Peninsula. 
 
 There have also been recent cases on the other side of Port Phillip Bay on the Bellarine Peninsula. 
 
 "We've been tracking this disease for 20 years now," Professor Stinear said. 
 
 "The bacteria that causes the disease has moved from Gippsland into Melbourne since the mid 1980s. 
 
 "The focus of the disease has definitely moved across the bay and it's now well embedded in the Mornington Peninsula." 
 
 13yo girl left with limp 
 
 One Mornington Peninsula teenager who recently contracted the disease has started an online petition calling on government to increase research for the disease. 
 
 Ella Crofts, 13, fell seriously ill after contracting Mycobacterium ulcerans, which attacked her right leg and left her with a large, raw and weeping wound on her knee. 
 
 "I've had six months of quality medical care and still have not recovered," she said on the petition webpage. 
 
 "This infection comes from the same family as leprosy and tuberculosis. How the disease is spread is unknown. There is currently no prevention against it. 
 
 "Thousands of people worldwide suffer from this infectious disease, most of them are in third-world countries. If we, a wealthy country, could research this disease we might save countless people from disfigurement and disability." 
 
 Throughout her slow recovery, Ella has had series of operations and months of medication. She said she now suffered from a limp. 
 
 Health Minister Greg Hunt said there was funding available for research. 
 
 "I have instructed the Chief Medical Officer to work with Victoria on looking for additional research proposals," Mr Hunt said. 
 
 He said $2.4 million in Commonwealth funding had already been provided to research the disease. 
 
 The Victorian Government hopes to launch a new module for GPs early next year to help them better identify and treat the wound. 
 
 Topics: health, diseases-and-disorders, medical-research, langwarrin-3910, mornington-3931, vic 
 
 First posted ||||| WARNING: Graphic images 
 
 When Ella Crofts began feeling a dull ache in her right knee, the last thing she imagined was that a flesh-eating ulcer was chewing through her skin. 
 
 "I started feeling pain in my knee in early April," the 13-year-old said. "Slowly, it got worse as my knee became swollen and inflamed until one day the skin started breaking down and I started to see an open wound that just kept getting bigger and bigger." 
 
 Ella was an otherwise active and healthy teenager from Tyabb when she was struck down with mycobacterium ulcerans (otherwise known as Buruli ulcer) in April. 
 
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 Link Ella Crofts contracted Mycobacterium Ulcerans - a life-threatening third-world condition that is running rampant on the Mornington Peninsula. Photo: Simon Schluter 
 
 A fast-growing outbreak on the Mornington Peninsula of the mysterious flesh-eating ulcer, previously largely confined to the developing world, has the health department puzzled and deeply concerned. 
 
 The annual number of Victorians diagnosed with Buruli ulcers has almost tripled in the past three years and doctors believe it will continue to rise. 
 
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 Geelong Hospital deputy director of infectious diseases, Associate Professor Daniel O'Brien said 'we don't know where it might appear next". 
 
 "It's getting more severe. We see now twice as many severe cases as we saw five years ago. And the biggest concern is we don't know how to prevent it," he said. 
 
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 Link Mycobacterium Ulcerans on Ella Croft's right knee. Photo: Supplied 
 
 Ella's local GP put her on strong antibiotics, but the wound continued to worsen. 
 
 Swab tests for bacteria came back negative and eventually Ella got a biopsy, which came back positive for mycobacterium ulcerans. 
 
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 Link An image of Mycobacterium Ulcerans, also known as the Buruli ulcer. Photo: Supplied 
 
 Since then, she has endured three operations to clean out the dead tissue around her knee and though the wound is slowly healing she still walks with a limp. 
 
 The schoolgirl started an online petition this week, calling for Health Minister Greg Hunt to provide more funding for research into the disease. 
 
 It has already garnered more than 7500 signatures. 
 
 Associate Professor O'Brien said the government had committed almost no funding to investigate the "epidemic". 
 
 "There is a complete knowledge vacuum. The only way to address it is to do some very thorough, basic scientific research. It needs to be done urgently and immediately, and it needs to be funded, and nobody is at this stage," he said. 
 
 Ella said until the government took the condition seriously people were at risk. 
 
 There have already been 159 recorded cases this year, up from 58 for the same time period in 2015. 
 
 "I would like the government to provide funding and equipment to research mycobacterium ulcerans so then we can find a quicker or more effective way to treat the condition," she said. 
 
 Mycobacterium's toxin decreases immune system function and results in tissue death. This infection comes from the same family as leprosy and tuberculosis. Experts think the bacterium may be spread by possums and mosquitoes, but no one is certain and it cannot be prevented. 
 
 A spokesman for the Department of Health and Human Services said it was providing funding to a range of programs investigating the outbreak. 
 
 "Experts from our public health laboratory and the department are currently engaged in collecting possum faeces from a number of locations on the Mornington Peninsula so that it can be analysed for the presence of the bacterium responsible for causing Buruli ulcer," the spokesman said. 
 
 Ulcers usually start as painless swellings that look like insect bites before growing into large lesions that can require major surgery to repair. 
 
 Cases of the ulcer are largely confined to countries in west and central Africa, including Benin, Cameroon and Ghana. 
 
 But in a mystery that continues to stump scientists, the bacterium has been causing ulcers in Victoria since the 1930s. Over the years there have been small outbreaks in East Gippsland, Phillip Island, and a major outbreak on the Bellarine Peninsula starting in 1998. 
 
 In 2012 it jumped to the Mornington Peninsula, and cases have now even been recorded in Melbourne's south-east suburbs, including Bentleigh, Hampton and Cheltenham. 
 
 How to avoid the Buruli ulcer:
– One of the least reassuring sentences you'll read this week: A flesh-eating bacterial infection that leads to "gaping, palm-sized ulcers" is on the rise, and experts have no idea how it's being spread. One of the more reassuring: It's happening in Victoria, Australia, so if you don't live there, you can read on with slightly less horror. Ars Technica reports that health authorities do know the bacterium at play—Mycobacterium ulcerans—and have recorded its rise from 47 infections in Victoria state in 2014 to 159 so far this year, reports Australia's ABC News. The infections do occur elsewhere in the world—generally in developing nations like Uganda, Nigeria, and Liberia—but a microbiologist terms the situation in Victoria an "epidemic." The organism comes from the same family of bacteria as leprosy and tuberculosis, and the Age reports that some scientists think possums and mosquitoes may be vectors. But that's just a theory at this point, and no prevention strategies have been developed. Antibiotics can typically successfully treat the infection, which most commonly occurs on the arms or legs, but it's a gruesome-looking, gangrene-like experience (see photos here if you can stomach them). 9News shares the case of 13-year-old Ella Crofts, who developed the infection in one of her knees in April. At first it just felt sore; ultimately, much of the kneecap had turned into an open sore. She had to undergo three surgeries to excise dead skin, and she's still walking with a limp. "We call it the zombie leg," her mother says. (This hiker barely survived an infection from a flesh-eating bacteria.)