Seaside Australia Faces a Rise in Flesh-Eating Buruli Ulcer Cases

He has treated more than 1,000 patients, both in Australia and overseas, for the disease. Many of those in Australia are older, but others are young teachers, laborers and even children.

He measures their lesions gently with a ruler, marking them to track their progression. Though they look like the stuff of nightmares — some have ulcers that eat all the way to the bone — most patients describe them as painless. The flesh-eating toxin produced by the bacteria presents a peculiar horror: It both weakens the immune response and numbs the flesh it is consuming. It’s “quite an extraordinary organism, really,” Dr. O’Brien said of the bacterium, “and a formidable foe.”

In Mr. Courtney’s case, the ulcer had ravaged the top half of his foot before doctors could give a diagnosis. They have since performed surgeries to remove the necrotic, concrete-like tissue. “Unless you get rid of that dead flesh, the skin will never heal,” said Dr. Adrian Murrie, a physician at the clinic who has been treating Mr. Courtney.

Other patients with less severe cases sometimes decline treatment, instead opting for natural remedies like applying heat and clay. Though the body can occasionally fight off smaller ulcers, such treatments can pose a real danger in serious cases, Dr. O’Brien said.

In most cases, the course of treatment is antibiotics. Previously, the disease was largely treated with surgery, but with better medications the prognosis has vastly improved in recent years. “It was thought the antibiotics didn’t work,” Dr. O’Brien said. “Because it actually gets worse before it gets better.”

Still, for now, prevention is close to impossible.

“We don’t know how to stop it,” he said. But if the answer is to be found anywhere, he said, it’s in Australia.

For Mr. Courtney, his battle with the disease is far from over. Doctors expect his treatment to last at least another six months.

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