dMycobacterium ulcerans is an emerging environmental pathogen that causes debilitating, ulcerative disease in humans and other vertebrates. The majority of human cases occur in tropical and temperate regions of Africa and Australia, and outbreaks of piscine mycobacteriosis caused by M. ulcerans have been reported in disparate geographic locations spanning the globe. While exposure to a natural body of water is the most common risk factor for human infection, the environmental distribution of M. ulcerans in aquatic habitats has not been extensively studied. Although no human cases have been reported in the United States, a strain of M. ulcerans has been identified as the cause of a piscine mycobacteriosis in Striped bass (Morone saxatilis) within the Chesapeake Bay. Infected fish exhibit bright red ventral and lateral dermal lesions. We observed a possible outbreak causing similar lesions on red drum (Sciaenops ocellatus) in wetlands of southern Louisiana and detected M. ulcerans-specific genetic markers in lesion samples from these fish. Based on these findings, we studied the geographic and seasonal prevalence of these markers across southern Louisiana. M. ulcerans was detected in each of the nine areas sampled across the state. M. ulcerans prevalence was significantly lower in the fall samples, and the low prevalence coincided with decreased nutrient levels and an increase in water temperature. To our knowledge, this is the first study of M. ulcerans biomarkers in the southern United States. Mycobacterium ulcerans is a pathogenic, toxin-producing bacterium that is the causative agent of Buruli ulcer (BU), a necrotizing skin infection in humans. Although the causative agent was discovered in the mid-1900s, BU remained a largely neglected tropical disease until the World Health Organization (WHO) established the Global Buruli Ulcer Initiative (GBUI) in 1998. M. ulcerans is currently recognized as a rapidly emerging pathogen. BU is endemic in 33 countries, with the highest number of cases occurring in tropical and subtropical regions of west and sub-Saharan Africa and Australia (1). In addition to human cases, M. ulcerans is responsible for disease in a wide range of other host species, including domestic and wild mammals (2-6), reptiles (7), amphibians (8), and fish (9, 10). Strains of M. ulcerans have increasingly been identified as the cause of piscine mycobacteriosis occurring in locations across the globe (9), including Israel (11), Europe (10,12), and the northeastern United States (13,14).Fundamental aspects of the ecology and epidemiology of M. ulcerans, including its environmental distribution, niche, host range, and mode of transmission and infection, are incompletely understood. The most definitive risk factor for BU is frequent contact with natural aquatic systems (15). This risk has been substantiated by studies that have shown that M. ulcerans is detected by PCR in samples collected from slow-flowing or stagnant bodies of water in areas with an incidence of BU (1). Within these aquatic environments,...
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