In recent years, cases of Buruli ulcer (BU) have increased dramatically in Victoria and the epidemic area has now expanded to include regions of the state’s two largest cities, Melbourne and Geelong. Cases of this chronic and debilitating disease of skin and soft tissue have increased by approximately 800% in 2022 in Geelong compared with 4 years previously. Previous studies have strongly indicated the importance of possums as a reservoir for Mycobacterium ulcerans in Victoria and a primary driver of its environmental circulation. Environmental surveys of possum faeces in Geelong and elsewhere have found that the distribution of M. ulcerans-positive possums correlates with human BU cases and appears to precede them in occurrence (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10154024/). This suggests that regular possum faecal surveillance could provide early warning of the ongoing spread of M. ulcerans and allow targeted public health campaigns. However, current surveillance methods utilise standard molecular testing methods which are both expensive and time consuming to perform. The development of a quicker, cheaper and field-deployable 'point-of-care' style methods would increase the feasibility of regular surveillance and enable quicker responses.
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