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Volume 31, Number 3—March 2025
Dispatch

Mycobacterium ulcerans in Possum Feces before Emergence in Humans, Australia

Bridgette J. McNamaraComments to Author , Jack Cornish, Kim R. Blasdell, Eugene Athan, Naomi E. Clarke, Tiffany Pe, Mohammad Akhtar Hussain, Michael Muleme, Ee Laine Tay, Michael Dunn, Victoria Boyd, Anjana Karawita, and Daniel P. O’Brien
Author affiliation: Barwon Health, Geelong, Victoria, Australia (B.J. McNamara, J. Cornish, E. Athan, N.E. Clarke, T. Pe, M.A. Hussain, M. Muleme, D.P. O'Brien); Centre for Innovation in Infectious Disease and Immunology Research, Geelong (B.J. McNamara, E. Athan, M.A. Hussain, M. Muleme, D.P. O'Brien); The University of Melbourne, Melbourne, Victoria, Australia (B.J. McNamara, D.P. O'Brien); CSIRO Australian Centre for Disease Preparedness, Geelong (K.R. Blasdell, M. Dunn, V. Boyd, A. Karawita); Deakin University, Geelong (E. Athan, T. Pe, M.A. Hussain); Victoria Department of Health, Melbourne (E.L. Tay)

Main Article

Figure 2

Distribution, clustering, and timing of Buruli ulcer cases in relation to Mycobacterium ulcerans–positive possum fecal samples, Victoria, Australia. A) Number and home location of human Buruli ulcer cases in Statistical Area SA1 in 2019–2020, compared with the distribution of M. ulcerans–positive possum fecal samples collected in the systematic main survey in 2020. Solid blue outline indicates areas in 2019 in which cases were tightly clustered during 2019; colored areas without borders had cases in 2020 only, B) Number and home location of human Buruli ulcer cases in Statistical Area SA1 in 2021–2022, compared with the distribution of M. ulcerans–positive possum fecal samples collected in the systematic main survey in 2020. Dashed blue outline indicates areas with cases only in 2021–2022 and not 2019–2020. Blue circles indicate 100-meter radius around the collection location. C) Spatiotemporal clustering of human Buruli ulcer cases from 2011–2022 in Geelong suburbs, Australia. The observed number of cases within each cluster are compared to the expected number for the estimated resident population of the area during the period (3), under the null hypothesis (no spatiotemporal clustering). D) Changing distribution of positive possum fecal samples from 2020 (blue) and 2022 (green).

Figure 2. Distribution, clustering, and timing of Buruli ulcer cases in relation to Mycobacterium ulcerans–positive possum fecal samples, Victoria, Australia. A) Number and home location of human Buruli ulcer cases in Statistical Area SA1 in 2019–2020, compared with the distribution of M. ulcerans–positive possum fecal samples collected in the systematic main survey in 2020. Solid blue outline indicates areas in 2019 in which cases were tightly clustered during 2019; colored areas without borders had cases in 2020 only, B) Number and home location of human Buruli ulcer cases in Statistical Area SA1 in 2021–2022, compared with the distribution of M. ulcerans–positive possum fecal samples collected in the systematic main survey in 2020. Dashed blue outline indicates areas with cases only in 2021–2022 and not 2019–2020. Blue circles indicate 100-meter radius around the collection location. C) Spatiotemporal clustering of human Buruli ulcer cases from 2011–2022 in Geelong suburbs, Australia. The observed number of cases within each cluster are compared to the expected number for the estimated resident population of the area during the period (3), under the null hypothesis (no spatiotemporal clustering). D) Changing distribution of positive possum fecal samples from 2020 (blue) and 2022 (green).

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