Spook house sporotrichosis. A point-source outbreak of sporotrichosis associated with hay bale props in a Halloween haunted-house

Abstract

While isolated cases of sporotrichosis typically occur following contact with contaminated plant materials, outbreaks are distinctly unusual. A temporal increase in the incidence of sporotrichosis in a dermatology practice at a military installation in southwestern Oklahoma prompted an investigation. Patients with sporotrichosis presenting to a single dermatologist in the winter of 1992-1993 were interviewed, epidemiological data were collected, and fungal cultures were obtained from incriminated hay fields. Five patients presented with cutaneous sporotrichosis during a 5-week period beginning in December 1992. Four patients had maintained hay bales in a Halloween haunted house and the fifth patient had visited the house once. As in 3 previous reports, this outbreak was associated with stored hay or hay bales harvested in the US plains states. Contact with hay should be recognized as a risk factor for infection with Sporothrix schenckii. Outbreaks are possible given adequate intensity of exposure and may be difficult to recognize because of the delayed presentation of clinical illness.

Epidemiology of sporotrichosis: A study of 304 cases in Brazil

“…[2][3][4][5]26 For this reason, sporotrichosis is considered to be acquired during outdoor leisure or occupational activities (eg, farming and gardening) that promote frequent and traumatic contact with plant material or soil. [27][28][29] In agreement with these observations, our study found that 74.3% of patients presented an occupational hazard, although no evident hazard could be established for the remaining 25.6% of patients.…”

Population‐Based Surveillance and a Case‐Control Study of Risk Factors for Endemic Lymphocutaneous Sporotrichosis in Peru

“…In the United States, LS in children has usually been reported in limited epidemics and small clusters [22][23][24][25]. With the exception of a previous report from this area [11], children are usually found to constitute only a minority of the patients with LS [12][13][14][15][16][26][27][28][29].…”

Disease-Causing Fungi in Homes and Yards in the Midwestern United States

“…Another outbreak was epidemiologically associated with bales of hay from a Halloween haunted house (there was no residual hay to culture, and cultures from the implicated fields 5 months after exposure were negative for S. schenckii). 67 Such bales are often purchased for yard decorations. The author is personally acquainted with a poorly controlled diabetic who died of disseminated sporotrichosis acquired via a thorn puncture from her home garden in Illinois.…”