Cluster of pulmonary blastomycosis in a rural community: evidence for multiple high-risk environmental foci following a sustained period of diminished precipitation.
Much of our understanding of the epidemiologic features of infection with Blastomyces dermatitidis has come from cluster and outbreak investigations which have established the association of human disease with recreational pursuits and the presence of infectious microfoci in areas of moist soil with high organic content. This report describes the clustering of eight cases of pulmonary blastomycosis without an apparent common source exposure which occurred during a 90 day period in a 96 square mile area (population 4,450) within Oconto County, Wisconsin. We conclude that multiple high-risk environmental foci may have existed following a sustained five-year period of diminished precipitation in the cluster area. A case-control study which included family and community controls concluded that multiple earth-disturbing activities engaged in by case-patients was statistically associated with illness. Lymphocyte-proliferation assays of whole blood samples detected previously unrecognized infection with B. dermatititidis among five of 32 family controls.
Proctor
Mary E
ME
Wisconsin Department at Health and Family Servcices, Division of Public Health, Bureau of Communicable Diseases, Madison 53701, USA. proctme@dhfs.state.wi.us
Klein
Bruce S
BS
Jones
Jeffrey M
JM
Davis
Jeffrey P
JP
D000293:Adolescent; D000328:Adult; D000818:Animals; D000908:Antibodies, Fungal / Q000032:analysis; D001758:Blastomyces / Q000276:immunology; D001759:Blastomycosis / Q000453:epidemiology* / Q000209:etiology / Q000662:veterinary; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004283:Dog Diseases / Q000453:epidemiology; D004285:Dogs; D005260:Female; D005656:Fungal Proteins; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000453:epidemiology* / Q000382:microbiology / Q000662:veterinary; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012988:Soil Microbiology; D014887:Weather; D014922:Wisconsin / Q000453:epidemiology
D000908:Antibodies, Fungal; D005656:Fungal Proteins; D006023:Glycoproteins