Victoria has seen a surge of cases of a flesh-eating bacteria, prompting warnings from the chief health officer to take protective measures after it spread through suburban Melbourne.
Buruli ulcer has been known to occur in Australia since the 1940s, with cases noted from Victoria to the Northern Territory and far-north Queensland.
Victoria's chief health officer, Prof Ben Cowie, on Friday warned the community about the risk of infection, after a recent increase in cases linked to the Melbourne suburb of Ascot Vale, in Melbourne's north.
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He said "cases remained high" across the state.
"The disease is spreading geographically across Victoria and is no longer restricted to specific coastal locations," he said in a health advisory.
As of 17 December, there have been 344 cases notified so far in 2024, compared with the same time in 2023 (362 cases), 2022 (338 cases), 2021 (286 cases), and 2020 (217 cases).
The state's health department said those affected usually develop a painless lump or wound, which can initially be mistaken for an insect bite. Over time the lesion slowly develops into a destructive skin ulcer.
Cowie said everyone was susceptible to infection, but Buruli ulcer notifications were highest in people aged over 60.
"Prompt treatment can significantly reduce skin loss and tissue damage, and avoid the need for more intensive treatment," he said.
"The incubation period varies from four weeks to nine months. The lesion of Buruli ulcer may occur anywhere on the body, but it is most common on exposed areas of the limbs."
Cowie advised people to use personal inspect repellents, cover up with light, loose, light-coloured clothing, and to avoid mosquito-prone areas or being outdoors during peak biting times.
Analysis recently published suggests Buruli has also become endemic in the New South Wales town of Batemans Bay, about 110km south-east of Canberra. Researchers have studied the coastal town's two only known cases, reported in 2021 and 2023, as well as picking apart 27 samples of possum poo. Victoria's department of health said possums were known to develop ulcers caused by this infection and research has shown that mosquitoes play a role in transmitting the disease to humans.