title: Spread of Cryptococcus gattii into Pacific Northwest region of the United States.
abstract: Cryptococcus gattii has emerged as a human and animal pathogen in the Pacific Northwest. First recognized on Vancouver Island, British Columbia, Canada, it now involves mainland British Columbia, and Washington and Oregon in the United States. In Canada, the incidence of disease has been one of the highest worldwide. In the United States, lack of cryptococcal species identification and case surveillance limit our knowledge of C. gattii epidemiology. Infections in the Pacific Northwest are caused by multiple genotypes, but the major strain is genetically novel and may have emerged recently in association with unique mating or environmental changes. C. gattii disease affects immunocompromised and immunocompetent persons, causing substantial illness and death. Successful management requires an aggressive medical and surgical approach and consideration of potentially variable antifungal drug susceptibilities. We summarize the study results of a group of investigators and review current knowledge with the goal of increasing awareness and highlighting areas where further knowledge is required.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: Kausik
authors.initials: K
authors.lastname: Datta
authors.forename: Karen H
authors.initials: KH
authors.lastname: Bartlett
authors.forename: Rebecca
authors.initials: R
authors.lastname: Baer
authors.forename: Edmond
authors.initials: E
authors.lastname: Byrnes
authors.forename: Eleni
authors.initials: E
authors.lastname: Galanis
authors.forename: Joseph
authors.initials: J
authors.lastname: Heitman
authors.forename: Linda
authors.initials: L
authors.lastname: Hoang
authors.forename: Mira J
authors.initials: MJ
authors.lastname: Leslie
authors.forename: Laura
authors.initials: L
authors.lastname: MacDougall
authors.forename: Shelley S
authors.initials: SS
authors.lastname: Magill
authors.forename: Muhammad G
authors.initials: MG
authors.lastname: Morshed
authors.forename: Kieren A
authors.initials: KA
authors.lastname: Marr
mesh_terms: D000818:Animals; D001955:British Columbia / Q000453:epidemiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000662:veterinary; D003453:Cryptococcosis / Q000453:epidemiology* / Q000662:veterinary; D003455:Cryptococcus neoformans / Q000145:classification / Q000302:isolation & purification / Q000472:pathogenicity; D004196:Disease Outbreaks; D017753:Ecosystem; D004783:Environmental Microbiology; D006801:Humans; D015205:Northwestern United States / Q000453:epidemiology; D011159:Population Surveillance; D011634:Public Health