Tourism and Specific Risk Areas for<i>Cryptococcus gattii</i>, Vancouver Island, Canada

Chambers, Catharine; MacDougall, Laura; Li, Min; Galanis, Eleni

doi:10.3201/eid1411.080532

Cited by 22 publications

(5 citation statements)

References 11 publications

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“…Molecular analysis established that the isolate was identical to the VGIIa/major genotype responsible for the Vancouver Island outbreak [37] . Additionally, a study from the British Columbia Centre for Disease Control indicated that intra-island travel or tourism on Vancouver Island to highly endemic areas increases the likelihood of contracting cryptococcosis [36] . These studies demonstrate the importance of human travel to endemic areas as it relates to the acquisition and presentation of cryptococcal disease.…”

Section: Discussionmentioning

confidence: 99%

“…While this is the first reported case in the Eastern United States, the suspected ecological niche is in the Western United States, and the patient's travel history is consistent with acquisition in the San Francisco metropolitan area. Travel to endemic areas is known to increase risk for C. gattii exposure and disease, and leads to acquisition in one region with presentation in a distant location [36] , [37] . The Australian case, California transplant patient, and North Carolina patient isolates are closely related to, but not identical at all noncoding genomic markers (VNTR) with Australian environmental isolates.…”

Section: Introductionmentioning

confidence: 99%

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First Reported Case of Cryptococcus gattii in the Southeastern USA: Implications for Travel-Associated Acquisition of an Emerging Pathogen

Byrnes

Lewit

et al. 2009

PLoS ONE

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In 2007, the first confirmed case of Cryptococcus gattii was reported in the state of North Carolina, USA. An otherwise healthy HIV negative male patient presented with a large upper thigh cryptococcoma in February, which was surgically removed and the patient was started on long-term high-dose fluconazole treatment. In May of 2007, the patient presented to the Duke University hospital emergency room with seizures. Magnetic resonance imaging revealed two large CNS lesions found to be cryptococcomas based on brain biopsy. Prior chest CT imaging had revealed small lung nodules indicating that C. gattii spores or desiccated yeast were likely inhaled into the lungs and dissemination occurred to both the leg and CNS. The patient's travel history included a visit throughout the San Francisco, CA region in September through October of 2006, consistent with acquisition during this time period. Cultures from both the leg and brain biopsies were subjected to analysis. Based on phenotypic and molecular methods, both isolates were C. gattii, VGI molecular type, and distinct from the Vancouver Island outbreak isolates. Based on multilocus sequence typing of coding and noncoding regions and virulence in a heterologous host model, the leg and brain isolates are identical, but the two differed in mating fertility. Two clinical isolates, one from a transplant recipient in San Francisco and the other from Australia, were identical to the North Carolina clinical isolate at all markers tested. Closely related isolates that differ at only one or a few noncoding markers are present in the Australian environment. Taken together, these findings support a model in which C. gattii VGI was transferred from Australia to California, possibly though an association with its common host plant E. camaldulensis, and the patient was exposed in San Francisco and returned to present with disease in North Carolina.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

First Reported Case of Cryptococcus gattii in the Southeastern USA: Implications for Travel-Associated Acquisition of an Emerging Pathogen

Byrnes

Lewit

et al. 2009

PLoS ONE

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“…Public media coverage was less helpful in conveying accurate information [82]. The economic consequences have yet to be tallied, and include the cost of hospitalizations, antifungal medications, and loss of tourism to the area [83]. The value to understanding this novel pathogen, however, has been enormous, as evidenced by the speed with which the genome sequencing has been undertaken by an international consortium of researchers [84].…”

Section: Environmental Aspects Of C Gattiimentioning

confidence: 99%

Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals

Byrnes

Bartlett

Perfect

et al. 2011

Microbes and Infection

138

120

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Infectious fungi are among a broad group of microbial pathogens that has and continues to emerge concomitantly due to the global AIDS pandemic as well as an overall increase of patients with compromised immune systems. In addition, many pathogens have been emerging and reemerging, causing disease in both individuals who have an identifiable immune defect and those who do not. The fungal pathogen Cryptococcus gattii can infect individuals with and without an identifiable immune defect, with a broad geographic range including both endemic areas and emerging outbreak regions. Infections in patients and animals can be severe and often fatal if untreated. We review the molecular epidemiology, population structure, clinical manifestations, and ecological niche of this emerging pathogen.

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“…Several reports have documented C. gattii cryptococcosis in visitors to BC and the USPNW [33][34][35][36][37][38]. In February 2007, the first known case of C. gattii infection in North Carolina was reported [37].…”

Section: Travel-associated Infectionmentioning

confidence: 99%

Cryptococcus gattii: Clinical Importance and Emergence in North America

Lockhart

Harris

2010

Curr Fungal Infect Rep

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Cryptococcus gattii is an emerging fungal pathogen in the Pacific Northwest of North America, where it has caused more than 50 human infections since its emergence in 2004. Among residents of British Columbia, where the disease emerged in 1999 on Vancouver Island, many infections have occurred in immunocompetent persons. The cause for the emergence is currently unknown. The pathogenic profile of Cryptococcus gattii in North American patients appears to be different from that seen previously for C. gattii and from the profile of infection among patients with Cryptococcus neoformans. Treatment duration and the need for patient follow-up may be different between patients infected with C. gattii and C. neoformans. For this reason, physicians treating atypical patients with Cryptococcal spp infection, particularly HIV-uninfected patients, should obtain a travel history and obtain a species identity for Cryptococcus isolates.

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Tourism and Specific Risk Areas forCryptococcus gattii, Vancouver Island, Canada

Cited by 22 publications

References 11 publications

First Reported Case of Cryptococcus gattii in the Southeastern USA: Implications for Travel-Associated Acquisition of an Emerging Pathogen

First Reported Case of Cryptococcus gattii in the Southeastern USA: Implications for Travel-Associated Acquisition of an Emerging Pathogen

Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals

Cryptococcus gattii: Clinical Importance and Emergence in North America

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