Incubation period Unknown

Occurrence and distribution Central Africa, Central and South America, Southeast Asia, Australia and New Guinea. Children and women living near rivers or wetlands in a rural region are predominantly affected. There has been a progressive increase in cases and more attention is being paid to working out the transmission and how to control the infection.

Control and prevention Several trials have been made with BCG vaccination and although these showed some early protection, it was not sustained. Health education in areas of high endemicity, with the provision of facilities for treating lesions as soon as they occur, has reduced the period of debility and the severity of the deformities.

Treatment Anti-mycobacterial drugs, such as streptomycin, dapsone, rifampicin or thiambutosine, have been found to be helpful, especially in the early stage, but essentially treatment is surgical with excision of the ulcer and skin grafting.

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