Dhungel Laxmi, Benbow Mark Eric, Jordan Heather Rose
Mississippi State University, Department of Biological Sciences, 295 Lee Blvd, Starkville, MS, USA.
Michigan State University, Department of Entomology and Department of Osteopathic Medicine, 243 Natural Science Bldg, 288 Farm Lane, East Lansing, MI 48824, USA.
One Health. 2021 Aug 18;13:100311. doi: 10.1016/j.onehlt.2021.100311. eCollection 2021 Dec.
Buruli ulcer (BU), the second most common mycobacterial disease in West Africa, is a necrotizing skin disease that can lead to high morbidity in affected patients. The disease is caused by whose major virulence factor is mycolactone. Although early infection can be treated with antibiotics, an effective preventative strategy is challenging due to unknown reservoir(s) and unresolved mode(s) of transmission. Further, disease occurrence in remote locations with limited access to health facilities further complicates disease burden and associated costs. We discuss here transmission hypotheses and investigations into environmental reservoirs and discuss successes and challenges of studying and Buruli ulcer across human, animal, and environmental interfaces. We argue that a One Health approach is needed to advance the understanding of transmission and designing management scenarios that prevent and respond to epidemics. Although previous work has provided significant insights into risk factors, epidemiology and clinical perspectives of disease, understanding the bacterial ecology, environmental niches and role of mycolactone in natural environments and during infection of the human host remains equally important to better understanding and preventing this mysterious disease.
布氏杆菌溃疡（BU）是西非第二常见的分枝杆菌病，是一种坏死性皮肤病，可导致受影响患者的高发病率。该疾病由 引起，其主要毒力因子是分枝杆菌内酯。虽然早期感染可用抗生素治疗，但由于未知的宿主和未解决的传播方式，有效的预防策略具有挑战性。此外，在偏远地区，获得卫生设施的机会有限，疾病的发生进一步加重了疾病负担和相关成本。我们在此讨论传播假说以及对环境宿主的调查，并讨论在人类、动物和环境界面研究 和布氏杆菌溃疡的成功经验和挑战。我们认为，需要一种“同一健康”方法来增进对 传播的理解，并设计预防和应对疫情的管理方案。尽管先前的工作对疾病的风险因素、流行病学和临床观点提供了重要见解，但了解细菌生态学、环境生态位以及分枝杆菌内酯在自然环境和人类宿主感染过程中的作用，对于更好地理解和预防这种神秘疾病同样重要。
