Insects in the transmission of Mycobacterium ulcerans infection

Portaels, Françoise; Elsen, P; Guimaraes-Peres, A; Fonteyne, Pierre-Alain; Meyers, Wayne M.

doi:10.1016/s0140-6736(98)05177-0

Cited by 233 publications

(204 citation statements)

References 5 publications

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“…Portaels and others 9 have implicated aquatic insects in the transmission of M. ulcerans infection; however, after continuous attempts, M. ulcerans has never been isolated from the environment.…”

Section: Introductionmentioning

confidence: 99%

The use of IS2404 restriction fragment length polymorphisms suggests the diversity of Mycobacterium ulcerans from different geographical areas.

Chemlal¹,

Ridder²,

Fonteyne³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Section: Introductionmentioning

confidence: 99%

The use of IS2404 restriction fragment length polymorphisms suggests the diversity of Mycobacterium ulcerans from different geographical areas.

Chemlal¹,

Ridder²,

Fonteyne³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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“…Most studies suggest that infection occurs through inoculation of M. ulcerans into skin lesions or insect bites (2,4,9-11). Portaels et al (11) were the fi rst to propose that aquatic insects might serve as vectors of M. ulcerans. This hypothesis maintains that M. ulcerans is found in biofi lms of aquatic habitats and concentrated by grazing or fi lter-feeding invertebrates that are then consumed by predators known to bite humans (11).…”

mentioning

confidence: 99%

“…Portaels et al (11) were the fi rst to propose that aquatic insects might serve as vectors of M. ulcerans. This hypothesis maintains that M. ulcerans is found in biofi lms of aquatic habitats and concentrated by grazing or fi lter-feeding invertebrates that are then consumed by predators known to bite humans (11). Initial evidence for this hypothesis used PCR detection of the insertion sequence IS2404 to document M. ulcerans' association with biting water bugs (Hemiptera), fi ltered concentrates of water, detritus, and aquatic plants (4,(12)(13)(14).…”

mentioning

confidence: 99%

Aquatic Invertebrates as Unlikely Vectors of Buruli Ulcer Disease

Benbow

Williamson

Kimbirauskas

et al. 2008

Emerg. Infect. Dis.

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Buruli ulcer is a necrotizing skin disease caused by Mycobacterium ulcerans and associated with exposure to aquatic habitats. To assess possible transmission of M. ulcerans by aquatic biting insects, we conducted a fi eld examination of biting water bugs (Hemiptera: Naucoridae, Belostomatidae, Nepidae) in 15 disease-endemic and 12 non-disease-endemic areas of Ghana, Africa. From collections of 22,832 invertebrates, we compared composition, abundance, and associated M. ulcerans positivity among sites. Biting hemipterans were rare and represented a small percentage (usually <2%) of invertebrate communities. No signifi cant differences were found in hemipteran abundance or pathogen positivity between disease-endemic and nondisease-endemic sites, and between abundance of biting hemipterans and M. ulcerans positivity. Therefore, although infection through insect bites is possible, little fi eld evidence supports the assumption that biting hemipterans are primary vectors of M. ulcerans. M ycobacterium ulcerans infection is an emerging skin disease often called Buruli ulcer (BU). Infection results in illness and lasting negative socioeconomic effects in rural areas of the tropics and subtropics (1). The pathologic changes, clinical signs and symptoms, and treatment have been reviewed elsewhere (2-5). In this article we evaluate fi eld evidence for the potential of aquatic invertebrates to be vectors of M. ulcerans.The exact mode of BU transmission remains unknown; however, past epidemiologic studies have associated BU with human activity near, or within, slow-fl owing or standing water bodies that have been created or disturbed by humans (2-4). Although several water-related risk factors have been recognized, none has been consistently reported, making it diffi cult to identify specifi c water-related risk activities (6-8). Most studies suggest that infection occurs through inoculation of M. ulcerans into skin lesions or insect bites (2,4,9-11). Portaels et al. (11) were the fi rst to propose that aquatic insects might serve as vectors of M. ulcerans. This hypothesis maintains that M. ulcerans is found in biofi lms of aquatic habitats and concentrated by grazing or fi lter-feeding invertebrates that are then consumed by predators known to bite humans (11). Initial evidence for this hypothesis used PCR detection of the insertion sequence IS2404 to document M. ulcerans' association with biting water bugs (Hemiptera), fi ltered concentrates of water, detritus, and aquatic plants (4,(12)(13)(14). These studies were important for understanding the possible environmental reservoirs of M. ulcerans. However, IS2404 is now understood to be not specifi c for M. ulcerans because this insertion sequence has been found in a number of other aquatic mycobacterial species, including M. marinum (15)(16)(17). When more discriminatory methods based on detection of variable number tandem repeats were used, many IS2404-positive environmental samples were reported to lack M. ulcerans (18). In light of these recent fi ndings, the relative fr...

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“…[1][2][3][4][5][6][7][8][9][10] Recent observations suggest that environmental sources of M. ulcerans include swamps, with subsequent transmission by insects. 11 The clinical features of Buruli ulcer are variable. In uncomplicated disease, painless skin ulcers, typically on the extremities, develop without fever or malaise.…”

mentioning

confidence: 99%

Transmission of Mycobacterium ulcerans to the nine-banded armadillo.

Walsh¹,

Meyers²,

Krieg³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Animal models for Mycobacterium ulcerans infections (Buruli ulcer) include guinea pigs, rats, and mice, but each has limitations in replicating the spectrum of human disease. Here, 19 adult nine-banded armadillos were inoculated intradermally with M. ulcerans. Injection sites were examined and skin samples obtained for histologic and microbiology studies. Necropsies were conducted to assess systemic involvement. In group 1 (n ϭ 4), 2 animals developed progressive skin ulcers with undermined borders at the injection sites within 6-10 weeks. Biopsies showed features similar to human disease including extensive necrosis in the deep dermis and subcutaneous fat, mixed cellular infiltrates, and acid-fast bacilli (AFB). In group 2 (n ϭ 15), 5 animals developed progressive skin ulcers, 3 had evanescent papulo-nodules, 3 died shortly after inoculation of unknown causes, and 4 showed no signs of infection. Lesion samples from 3 animals with progressive ulcers were culture positive for AFB. Our findings indicate that nine-banded armadillos are susceptible to M. ulcerans and may develop cutaneous lesions that closely mimic Buruli ulcer.In tropical countries, skin ulcers caused by infectious agents are common. Mycobacterium ulcerans, the causative organism of Buruli ulcer first isolated in Australia, is considered a public health threat, especially in Africa. [1][2][3][4][5][6][7][8][9][10] Recent observations suggest that environmental sources of M. ulcerans include swamps, with subsequent transmission by insects. 11 The clinical features of Buruli ulcer are variable. In uncomplicated disease, painless skin ulcers, typically on the extremities, develop without fever or malaise. 12,13 However, progressive lesions may result in large areas of ulceration, necrosis, and osteomyelitis. Many lesions tend to heal, but this may take years without medical intervention. Advanced disease requires surgical excision and skin grafts or amputation. Crippling contractures and lymphedema may accompany healing. Medical therapies include clofazimine, dapsone, rifampicin, phenytoin, cotrimoxazole, macrolide compounds, and heat. However, cure rates are generally low. [14][15][16][17][18][19] Understanding the pathogenesis of human M. ulcerans infections has been slowed by the lack of an animal model that develops features resembling human disease. Rats, mice, and guinea pigs are used as animal models for M. ulcerans infections, but each is limited in replicating the spectrum of features found in human disease. Rats and mice develop lesions after cutaneous inoculation with M. ulcerans, but lack the extensive ulceration characteristic of human disease. In the mouse footpad, the organisms multiply but necrosis without ulceration destroys the limb and causes death. 20,21 Guinea pigs develop inflammatory lesions at the inoculation sites that usually resolve without ulcer formation. 21,22 The nine-banded armadillo is highly susceptible to M. leprae and has been a useful animal model for leprosy. 23 Here, we report that armadillos are also s...

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Insects in the transmission of Mycobacterium ulcerans infection

Cited by 233 publications

References 5 publications

The use of IS2404 restriction fragment length polymorphisms suggests the diversity of Mycobacterium ulcerans from different geographical areas.

The use of IS2404 restriction fragment length polymorphisms suggests the diversity of Mycobacterium ulcerans from different geographical areas.

Aquatic Invertebrates as Unlikely Vectors of Buruli Ulcer Disease

Transmission of Mycobacterium ulcerans to the nine-banded armadillo.

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