First Description of a Cluster of Acute/Subacute Paracoccidioidomycosis Cases and Its Association with a Climatic Anomaly

Abstract

BackgroundIdentifying clusters of acute paracoccidioidomycosis cases could potentially help in identifying the environmental factors that influence the incidence of this mycosis. However, unlike other endemic mycoses, there are no published reports of clusters of paracoccidioidomycosis.Methodology/Principal FindingsA retrospective cluster detection test was applied to verify if an excess of acute form (AF) paracoccidioidomycosis cases in time and/or space occurred in Botucatu, an endemic area in São Paulo State. The scan-test SaTScan v7.0.3 was set to find clusters for the maximum temporal period of 1 year. The temporal test indicated a significant cluster in 1985 (P<0.005). This cluster comprised 10 cases, although 2.19 were expected for this year in this area. Age and clinical presentation of these cases were typical of AF paracccidioidomycosis. The space-time test confirmed the temporal cluster in 1985 and showed the localities where the risk was higher in that year. The cluster suggests that some particularities took place in the antecedent years in those localities. Analysis of climate variables showed that soil water storage was atypically high in 1982/83 (∼2.11/2.5 SD above mean), and the absolute air humidity in 1984, the year preceding the cluster, was much higher than normal (∼1.6 SD above mean), conditions that may have favored, respectively, antecedent fungal growth in the soil and conidia liberation in 1984, the probable year of exposure. These climatic anomalies in this area was due to the 1982/83 El Niño event, the strongest in the last 50 years.Conclusions/SignificanceWe describe the first cluster of AF paracoccidioidomycosis, which was potentially linked to a climatic anomaly caused by the 1982/83 El Niño Southern Oscillation. This finding is important because it may help to clarify the conditions that favor Paracoccidioides brasiliensis survival and growth in the environment and that enhance human exposure, thus allowing the development of preventive measures.

Hormones and the Resistance of Women to Paracoccidioidomycosis

“…In Brazil, ecological correlates obtained through spatial analyses indicate that moisture availability plays an important role in PCM distribution (9). This methodology recently revealed the existence of a cluster of acute/subacute cases potentially linked to a climatic anomaly caused by the 1982-1983 El Niño Southern Oscillation phenomenon (8).…”

Fatal Fungemia due to Paracoccidioides lutzii

“…Recently, Arantes and others 27 reported environmental nucleic acid sequences belonging to P. lutzii in the hyperendemic region of Botucatu in the southeast region of Brazil, 27 an area formerly assumed to have a high prevalence of species S1. [2][3][4] However, no increase in clinical cases of PCM caused by P. lutzii has been seen in areas others than the central-west region of Brazil, which could be related to differences in the survival and growth of this species in nature, differences in human exposure, or even host resistance to infection in this area, and the misidentification of this pathogenic species by currently available techniques.…”

Paracoccidioidomycosis: level of pulmonary sequelae in high resolution computed tomography images from patients of two endemic regions of Brazil

“…Prevention of human exposure to P. brasiliensis may be achieved if their survival and growth conditions are known, which can be possible by studying the geographical distribution of PCM (30). Studies have reported only the morphology of the different species, and the different levels of compromise that each species causes still need to be determined (31).…”