1998 Dengue Hemorrhagic Fever Epidemic in Taiwan

patients. Two of these five had concurrent S. haematobium, compared to no cases in nonosteomyelitis patients; a Fisher exact test showed this difference to be significant (p < 0.02). These limited and preliminary data are consistent with the relationship between leprosy (caused by a mycobacterium related to the one causing Buruli ulcer, M. leprae) and concurrent helminth infections. The severity of leprosy has recently been linked to intestinal helminth infection, whereas the presence or absence of leprosy has not (7). The cytokine environment created by helminth infection may facilitate disease progression to a more severe form, or severe mycobacterial disease and helminth infection may have a common risk factor. We were unable to furnish evidence of a link between the presence or absence of S. haematobium infection and Buruli ulcer, but concurrent infections could influence Buruli ulcer clinical manifestation and disease severity.