OR32

1:University of Melbourne

In the 1990s the epidemiology in temperate southeastern Australia of the neglected tropical skin disease, Buruli ulcer (BU) - infection of subcutaneous tissue with Mycobacterium ulcerans – changed. From a handful of BU cases reported from rural regions in the eastern area of the state of Victoria, increasing cases began to be reported around the major metropolitan city of Melbourne and the regional centre of Geelong in the state of Victoria, in southeast Australia. Today BU is endemic in these major urban centres, with more than 350 cases reported each year. We have been attempting to address the longstanding question of how M. ulcerans is spreading from the environment to humans. Using a combination of extensive field surveillance, pathogen genomics, computational science, and field intervention studies, we have discovered that native possums are a major wildlife reservoir of the pathogen and that mosquitoes are mechanical vectors. These findings have led to the first evidence-based opportunities to intervene in the transmission of BU.