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About the Authors:
Michael J. Loftus
Roles Data curation, Formal analysis, Investigation, Writing - original draft, Writing - review & editing
* E-mail: [email protected]
Affiliations Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia, Victorian Department of Health and Human Services, Melbourne, Victoria, Australia
ORCID http://orcid.org/0000-0001-6672-0578
Jason A. Trubiano
Roles Conceptualization, Data curation, Investigation, Writing - review & editing
Affiliations Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia, Department of Medicine, Melbourne University, Parkville, Victoria, Australia
Ee Laine Tay
Roles Data curation, Formal analysis, Methodology, Writing - review & editing
Affiliation: Victorian Department of Health and Human Services, Melbourne, Victoria, Australia
Caroline J. Lavender
Roles Writing - review & editing
Affiliation: Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
Maria Globan
Roles Writing - review & editing
Affiliation: Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
Janet A. M. Fyfe
Roles Conceptualization, Supervision, Writing - review & editing
Affiliation: Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia
Paul D. R. Johnson
Roles Conceptualization, Methodology, Supervision, Writing - review & editing
Affiliations Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia, Department of Medicine, Melbourne University, Parkville, Victoria, AustraliaAbstract
Background
Buruli ulcer (BU) is a geographically-restricted infection caused by Mycobacterium ulcerans; contact with an endemic region is the primary risk factor for disease acquisition. Globally, efforts to estimate the incubation period of BU are often hindered as most patients reside permanently in endemic areas. However, in the south-eastern Australian state of Victoria, a significant proportion of people who acquire BU are visitors to endemic regions. During a sustained outbreak of BU on the Bellarine peninsula we estimated a mean incubation period of 4.5 months. Since then cases on the Bellarine peninsula have declined but a new endemic area has developed centred on the Mornington peninsula.
Method
Retrospective review of 443 cases of BU notified in Victoria between 2013 and 2016. Telephone interviews were performed to identify all cases with a single visit to an endemic region, or multiple visits within a one month period. The incubation period was defined as the time between exposure to an endemic region and symptom onset. Data were subsequently combined with those from our earlier study incorporating cases from 2002 to 2012.
Results
Among the 20 new...