Volume 187 - Issue 1
Mycobacterium ulcerans infection: an eponymous ulcer
Authors: Paul D R Johnson and John A Hayman
Med J Aust 2007; 187 (1): 63. || doi: 10.5694/j.1326-5377.2007.tb01137.x
Published online: 2 July 2007
Published online: 2 July 2007
“What’s in a name? That which we call a rose
By any other name would smell as sweet.”
— William Shakespeare,
Romeo and Juliet; II, ii, 1-2; circa 1595
Comment: In 1948, MacCallum and colleagues published an article reporting a new mycobacterial infection in man,1 and later named the causative organism Mycobacterium ulcerans. In their article, they described six patients, five of whom came from the Bairnsdale district in Gippsland, Victoria. Three Bairnsdale general practitioners, Drs Alsop, Clay and Searls, had initially recognised a novel disease in their region and submitted pathological specimens to Melbourne University for diagnosis.2
Subsequently, the same disease was described in many different areas, mostly in Africa (“Buruli ulcer”). Each new outbreak tended to give rise to a new name; of all these, perhaps the most colourful is “Sik belong Sepik”, describing the infection as it occurs along the Sepik River in Papua New Guinea. In Victoria, where most Australian cases of M. ulcerans infection occur,3 we have continued to use the term “Bairnsdale ulcer” even though the main endemic areas are now the Bellarine and Mornington Peninsulas near Melbourne.3
Medical eponyms have a place for diseases that are poorly understood or have unknown causes, but it could be argued that the terms “Bairnsdale ulcer” and “Buruli ulcer” now belong in the annals of medical history.
However, there are other considerations. In 1998, the World Health Organization launched the Global Buruli Ulcer Initiative.4 This successful advocacy raised the profile of this neglected disease and facilitated major improvements in diagnosis and treatment.
For better or worse, “Buruli ulcer” has become the internationally recognised term for M. ulcerans infection, and we propose that we should now also adopt this name in Australia. While this should come as a relief to the good citizens of Bairnsdale and the Bellarine peninsula, what about those of Buruli in Uganda? Fortunately, their county has been renamed and is now known as the Nakasongola District.5
References
- MacCallum P, Tolhurst JC, Buckle G, Sissons HA. A new mycobacterial infection in man. J Pathol Bacteriol 1948; 60: 93-122.<eMJA full text>
- Alsop D. The Bairnsdale ulcer. Aust N Z J Surg 1972; 41: 317-319. 0_pgfId-1271359
- Johnson PDR, Hayman JA, Quek TY, et al. Consensus recommendations for the diagnosis, treatment and control of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer) in Victoria, Australia. Med J Aust 2007; 186: 64-68. 0_CBBDFDFG
- World Health Organization. Buruli ulcer. Global Buruli ulcer initiative. http://www.who.int/buruli/en/ (accessed Apr 2007).
- World Health Organization. Media centre. Buruli ulcer disease. Fact sheet No. 199. Revised March 2007. http://www.who.int/mediacentre/factsheets/fs199/en/index.html (accessed Apr 2007).