Persistence of the disease is due to a combination of factors, some of which are a long incubation period and persistence of nasopharyngeal carriage after antimicrobial treatment. Mycobacterium ulcerans has been implicated in cases that have occurred in the Australian state of Victoria. Buruli's ulcer, as it is otherwise known, was first detected in Australia in 1948 and is an endemic disease. The mode of transmission is unknown and environmental factors are known to play a role in transmission. The disease starts as a painless swelling and progresses to form deforming ulcers which if left untreated, can result in amputation of limbs and loss of organs.
Surgical excision is the only known treatment.
An 8 year-old boy in Washington state, USA continues to struggle with necrotizing fasciitis, for nearly a month after contracting the disease. Amputation of a limb and extensive removal of tissue were necessary to prevent the infection from spreading further. Though Group A streptoccus is the most common organism that causes necrotizing fasciitis, other bacteria can also produce the same disease. Prompt diagnosis and treatment are critical in preventing death, and limb and skin loss. The results were based on low seroprevalence of antibodies to H5N1 among 154 exposed, and non-exposed health care workers.