An outbreak of blastomycosis in Eastern Tennessee

Frye, Michael D.; Seifer, Frederic D.

doi:10.1007/bf00436085

Cited by 18 publications

(3 citation statements)

References 12 publications

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“…Prior investigations of presumed common source outbreaks have linked acquisition of infection with exposure to construction sites, [20][21][22] living near a peanut farm, 23 raccoon hunting in swampy woods, 24 canoeing and fishing on Wisconsin rivers, 25,26 digging in an underground fort and animal burrow, 26 and visiting a beaver dam and lodge. 8 In the only other recorded non-rural outbreak, case patients were presumably infected during exposure to heavy airborne dust while residing or driving near suburban Chicago road construction excavation sites.…”

Section: Discussionmentioning

confidence: 99%

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

Pfister

Archer²,

Hersil³

et al. 2010

Clinical Medicine & Research

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Background: Blastomycosis is a potentially fatal infection caused by the fungus Blastomyces dermatitidis.During January 1 through March 5, 2006, twenty-one laboratory confirmed cases of blastomycosis were reported among residents of an endemic area in north-central Wisconsin; a striking increase compared with previous years. The objective of the study was to determine if an observed increase in blastomycosis among residents of an urban area in north-central Wisconsin was caused by a pointsource exposure and to identify its source. Methods:We compared epidemiologic features, and signs and symptoms of B. dermatitidis infection among 46 historic (1999)(2000)(2001)(2002)(2003)(2004)(2005) and 21 possible outbreak case patients. In addition, a case-control study was conducted to compare risk factors of the outbreak case patients with those of 64 age, gender, and geographically-matched control subjects. We conducted site inspections, evaluated meteorological data, genetically compared outbreak and non-outbreak isolates, and attempted environmental detection of B. dermatitidis using polymerase chain reaction, in vitro isolation, and in vivo isolation by tail vein injection of mice. Results:The unusual risk profile of this outbreak included: residence within non-rural city limits with limited time spent outdoors and an equivalent gender ratio and young median age among case patients consistent with common source rather than unrelated exposures. Thirteen of fourteen outbreakassociated clinical isolates of B. dermatitidis clustered in the same genetic group by PCR-RFLP analysis. Inspections near the cluster center suggested a yard waste collection site as the probable exposure source. B. dermatitidis nucleic acid was detected in one of 19 environmental samples. Environmental and meteorological conditions and material management practices were identified that may have facilitated growth and dispersal of B. dermatitidis conidia near this residential area. Conclusions:Results of our investigation of this large non-rural outbreak of blastomycosis suggest bioaerosol hazards may exist near yard waste collection and composting facilities, especially where pine tree litter is present, in B. dermatitidis endemic areas.

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Section: Discussionmentioning

confidence: 99%

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

Pfister

Archer²,

Hersil³

et al. 2010

Clinical Medicine & Research

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“…Human activities that disrupt soil (e.g., home and road construction, exploration of beaver dams or underground forts, use of a community compost pile, hunting, clearing brush, or cutting trees) or involve water (e.g., canoeing, boating, fishing) have been associated with the acquisition of B. dermatitidis as well as outbreaks of disease (►Table 1). 5,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Epidemiologic knowledge about B. dermatitidis is limited because the data are based on passive surveillance and retrospective studies. Blastomycosis is reportable in six states (WI, MN, MO, AK, LA, and MS) and two provinces (Ontario, Manitoba).…”

Section: Geographic Distribution and Epidemiologymentioning

confidence: 99%

New Developments in Blastomycosis

Smith

Gauthier

2015

Semin Respir Crit Care Med

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Blastomyces dermatitidis, the etiologic agent of blastomycosis, is a thermally dimorphic fungus that grows as a filamentous mold in the environment and as budding yeast in human tissue. This pathogen is endemic to North America, particularly in the states bordering the Mississippi and Ohio rivers, the Great Lakes, and the St. Lawrence Seaway. Infection with B. dermatitidis causes a broad array of clinical manifestations ranging from asymptomatic infection to fulminant sepsis with acute respiratory distress syndrome and death. B. dermatitidis can infect almost any organ in the body, but has a predilection for lungs and skin. There have been recent advances in the understanding of the pathogenesis, diagnosis, and treatment of this fungus. The Infectious Diseases Society of America published updated guidelines in 2008 to guide clinicians in the treatment of this important pathogen.

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“…Outbreaks have been reported in multiple states with and without mandatory reporting [7], [13]–[16]. A recent large outbreak in Wisconsin during 2010 [13] highlighted the need for an updated epidemiologic assessment of this disease.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Trends of Blastomycosis-Associated Hospitalizations in the United States

et al. 2014

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We used the State Inpatient Databases from the United States Agency for Healthcare Research and Quality to provide state-specific age-adjusted blastomycosis-associated hospitalization incidence throughout the entire United States. Among the 46 states studied, states within the Mississippi and Ohio River valleys had the highest age-adjusted hospitalization incidence. Specifically, Wisconsin had the highest age-adjusted hospitalization incidence (2.9 hospitalizations per 100,000 person-years). Trends were studied in the five highest hospitalization incidence states. From 2000 to 2011, blastomycosis-associated hospitalizations increased significantly in Illinois and Kentucky with an average annual increase of 4.4% and 8.4%, respectively. Trends varied significantly by state. Overall, 64% of blastomycosis-associated hospitalizations were among men and the median age at hospitalization was 53 years. This analysis provides a complete epidemiologic description of blastomycosis-associated hospitalizations throughout the endemic area in the United States.

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An outbreak of blastomycosis in Eastern Tennessee

Cited by 18 publications

References 12 publications

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

New Developments in Blastomycosis

Incidence and Trends of Blastomycosis-Associated Hospitalizations in the United States

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