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spread from one person to another. In areas endemic for Buruli ulcer, disease occurs near stagnant bodies of water, leading to the long-standing hypothesis that M. ulcerans is somehow transmitted to humans from aquatic environments. M. ulcerans is widespread in these environments, where it can survive as free-living or in association with other aquatic organisms. Live M. ulcerans has been isolated from aquatic insects, mosses, and animal feces, and its DNA has been

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