Definingnew Buruli ulcer endemic areas in urban southeastern Australia using bacterial genomics-informed possum excreta surveys

Abstract

Buruli ulcer in southeastern Australia is a zoonosis caused by infection with Mycobacterium ulcerans. Australian native possums are a major wildlife reservoir, and infected possums shed M. ulcerans in their excreta, with mosquitoes being the major transmitting vector in this region. Buruli ulcer is geographically restricted, and this feature, combined with an average 4.8-month incubation period, makes tracking M. ulcerans environmental spread and timely identificationof new Buruli ulcer endemic areas challenging. While human mobility complicates transmission tracing, we used the highly territorial behavior of native possums and high-resolution pathogen genomics to confidentlyidentify new Bur..