Serologic survey for exposure following fatal Balamuthia mandrillaris infection.
Granulomatous amebic encephalitis (GAE) from Balamuthia mandrillaris, a free-living ameba, has a case fatality rate exceeding 90% among recognized cases in the USA. In August 2010, a GAE cluster occurred following transplantation of infected organs from a previously healthy landscaper in Tucson, AZ, USA, who died from a suspected stroke. As B. mandrillaris is thought to be transmitted through soil, a serologic survey of landscapers and a comparison group of blood donors in southern Arizona was performed. Three (3.6%) of 83 serum samples from landscapers and 11 (2.5%) of 441 serum samples from blood donors were seropositive (p = 0.47). On multivariable analysis, county of residence was associated with seropositivity, whereas age, sex, and ethnicity were not. Exposure to B. mandrillaris, previously unexamined in North America, appears to be far more common than GAE in Southern Arizona. Risk factors for disease progression and the ameba's geographic range should be examined.
Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, USA, iyn0@cdc.gov.
Brendan R
BR
Jackson
Zuzana
Z
Kucerova
Sharon L
SL
Roy
Glenda
G
Aguirre
Joli
J
Weiss
Rama
R
Sriram
Jonathan
J
Yoder
Rebecca
R
Foelber
Steven
S
Baty
Gordana
G
Derado
Susan L
SL
Stramer
Valerie
V
Winkelman
Govinda S
GS
Visvesvara
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000562:Amebiasis / Q000097:blood* / Q000401:mortality; D001130:Arizona; D059611:Balamuthia mandrillaris / Q000472:pathogenicity*; D001782:Blood Donors; D003430:Cross-Sectional Studies; D004660:Encephalitis / Q000097:blood / Q000401:mortality; D005260:Female; D051639:Gardening; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012987:Soil / Q000469:parasitology; D055815:Young Adult
D012987:Soil