Buruli ulcer

​Buruli ulcer is a skin disease caused by the bacterium Mycobacterium ulcerans. There are very few cases in NSW however it is endemic in parts of Victoria and Far North Queensland. A very small number of cases have been detected on the south coast of NSW at Batemans Bay. If you live or visit this area, be alert to signs of Buruli ulcer and speak to your doctor if you are worried about any ulcers, wounds or bites. 

Last updated: 06 January 2025
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​​What is Buruli ulcer?

Buruli ulcer is a bacterial skin disease that damages the skin and soft tissue. It is usually found on arms and legs.

If it is not treated, the ulcers can become larger causing a loss of skin and muscle. It can also lead to disability. Buruli ulcer is commonly present in tropical and subtropical areas around the world. In Australia, it is common in Far North Queensland and Victoria. There have been some cases in New South Wales, but this is not common. Avoiding infection, finding out early and getting treatment is very important.

The bacteria that cause Buruli ulcer are in the environment. In Australia, it is likely that mosquitoes play a role in transmitting the bacteria. People may be infected with the bacteria after being bitten by a mosquito.

Buruli ulcer is sometimes called Bairnsdale ulcer, Daintree ulcer or Mossman ulcer.


How is Buruli ulcer spread?

In Australia, Buruli ulcer most likely spreads to humans from mosquitoes carrying the bacteria. However, the bacteria that cause Buruli ulcer may also exist in soil or water in the environment.

People with a Buruli ulcer cannot spread it to other people.

What are the symptoms of Buruli ulcer?​

Initial signs of Buruli ulcer include a painless lump, normally formed on the arms, legs or face.

Over time the lump grows into a painless ulcer. Symptoms often appear 4-5 months after exposure.

If not treated, the ulcer will continue to grow into the skin tissue, muscle and bone. Sometimes the infection will not cause an ulcer. It may produce a lump, a rough patch on the skin, localised swelling or fever. 


Who is at risk of Buruli ulcer? 

Anyone who is exposed to the bacteria may develop Buruli ulcer. People at greater risk include people who work or spend time outdoors or near soil or stagnant water.  

​To find out where Buruli ulcer is common visit World Health Organisa​​tion, Victorian Department of Health and HealthDirect.

How is Buruli ulcer prevented?

​​​​There is no vaccine for Buruli ulcer.


The best way to avoid getting sick, especially if you are in an area where Buruli ulcer is common, is to avoid mosquito bites:

  • Cover up: Wear light-coloured, long-sleeved shirts, long pants and enclosed shoes. Mosquitoes can bite through tight clothes.
  • Spray up: Apply mosquito repellent with picaridin, DEET or oil of lemon eucalyptus to all exposed skin. Natural or homemade repellents offer limited protection. Read the instructions to know when to reapply. Always apply sunscreen before repellent. Mosquito wristbands and patches are not recommended as there is no evidence that they provide good protection against mosquito bites.
  • Clean up: Remove stagnant water around the home to stop mosquito breeding sites. 
  • Screen up: Use mosquito nets, and screen windows and doors. 
  • Be extra careful during sunrise and sunset as these are the peak times when mosquitoes bite. 
  • Clean and cover cuts and grazes.
  • Be extra careful when travelling in areas with a higher risk of mosquito-borne diseases.
  • Where possible, limit outdoor activity if lots of mosquitoes are about, especially in areas near swamps and wetlands.

For more information see the Mosquitoes are a Health Hazard factsheet

How is Buruli ulcer diagnosed and treated?

Visit your doctor if you think you have a Buruli ulcer infection. They will check your skin and may take a sample for testing. They may also ask if you have visited areas known to have Buruli ulcer, such as Victoria or Far North Queensland.  

If you have Buruli ulcer, your doctor will prescribe oral antibiotics for 6-8 weeks. Sometimes surgery may be required. 


What is the public health response to Buruli ulcer?

Buruli ulcer is a notifiable disease in NSW.

This means that doctors and laboratory services need to inform their local public health unit of any cases of Buruli ulcer.

This helps to identify cases and outbreaks of Buruli ulcer. It also means NSW Health can provide you and the community, advice on how to reduce the risk of Buruli ulcer. ​


Additional resources

For further advice, see:
Current as at: Monday 6 January 2025
Contact page owner: One Health