Epidemic of Pulmonary Blastomycosis (Namekagon Fever) in Wisconsin Canoeists

Cockerill, Franklin R.; Roberts, Glenn D.; Rosenblatt, Jon E.; Utz, John P.; Utz, David C.

doi:10.1378/chest.86.5.688

Cited by 70 publications

(30 citation statements)

References 6 publications

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“…Prior investigations of presumed common source outbreaks have linked acquisition of infection with exposure to construction sites, [20][21][22] living near a peanut farm, 23 raccoon hunting in swampy woods, 24 canoeing and fishing on Wisconsin rivers, 25,26 digging in an underground fort and animal burrow, 26 and visiting a beaver dam and lodge. 8 In the only other recorded non-rural outbreak, case patients were presumably infected during exposure to heavy airborne dust while residing or driving near suburban Chicago road construction excavation sites.…”

Section: Discussionmentioning

confidence: 99%

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Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

Pfister

Archer²,

Hersil³

et al. 2010

Clinical Medicine & Research

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Background: Blastomycosis is a potentially fatal infection caused by the fungus Blastomyces dermatitidis.During January 1 through March 5, 2006, twenty-one laboratory confirmed cases of blastomycosis were reported among residents of an endemic area in north-central Wisconsin; a striking increase compared with previous years. The objective of the study was to determine if an observed increase in blastomycosis among residents of an urban area in north-central Wisconsin was caused by a pointsource exposure and to identify its source. Methods:We compared epidemiologic features, and signs and symptoms of B. dermatitidis infection among 46 historic (1999)(2000)(2001)(2002)(2003)(2004)(2005) and 21 possible outbreak case patients. In addition, a case-control study was conducted to compare risk factors of the outbreak case patients with those of 64 age, gender, and geographically-matched control subjects. We conducted site inspections, evaluated meteorological data, genetically compared outbreak and non-outbreak isolates, and attempted environmental detection of B. dermatitidis using polymerase chain reaction, in vitro isolation, and in vivo isolation by tail vein injection of mice. Results:The unusual risk profile of this outbreak included: residence within non-rural city limits with limited time spent outdoors and an equivalent gender ratio and young median age among case patients consistent with common source rather than unrelated exposures. Thirteen of fourteen outbreakassociated clinical isolates of B. dermatitidis clustered in the same genetic group by PCR-RFLP analysis. Inspections near the cluster center suggested a yard waste collection site as the probable exposure source. B. dermatitidis nucleic acid was detected in one of 19 environmental samples. Environmental and meteorological conditions and material management practices were identified that may have facilitated growth and dispersal of B. dermatitidis conidia near this residential area. Conclusions:Results of our investigation of this large non-rural outbreak of blastomycosis suggest bioaerosol hazards may exist near yard waste collection and composting facilities, especially where pine tree litter is present, in B. dermatitidis endemic areas.

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Section: Discussionmentioning

confidence: 99%

“…4 Recent rainfall was reported prior to the environmental recovery of B. dermatitidis following several documented point source outbreaks. 15,25,[33][34][35] All of these environmental conditions existed prior to and during the estimated exposure period of this outbreak.…”

Section: Discussionmentioning

confidence: 99%

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

Pfister

Archer²,

Hersil³

et al. 2010

Clinical Medicine & Research

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“…The median incubation period for cutaneous inoculation blastomycosis was only 2 weeks. The incubation period for blastomycosis related to respiratory exposure is notably longer; in 2 outbreaks, the median incubation periods were 45 days [21] and 30 days [22], and the incubation period ranged from 33 to 44 days in 1 outbreak [23].…”

Section: Discussionmentioning

confidence: 99%

MAJOR ARTICLE: Cutaneous Inoculation Blastomycosis

Gray

Baddour

2002

CLIN INFECT DIS

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“…Hobbies such as hunting [86], camping, and canoeing along waterways in endemic areas are associated with blastomycosis [96]. In seven of the 12 reported blastomycosis outbreaks, the participation in recreational activities in forests along lakes and rivers was determined to be the risk factor [15].…”

Section: Hobbies and Ifismentioning

confidence: 99%

Occupation, Lifestyle, Diet, and Invasive Fungal Infections

Sipsas

Kontoyiannis

2008

Infection

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Many professions, especially those involving outdoor activities, are associated with increased environmental exposure to pathogenic fungi and, subsequently, increased risk of IFIs. Inhalation and direct inoculation through minor skin lesions are the most common mechanisms of fungal infection. In addition, different lifestyle practices, such as smoking tobacco or marijuana, body piercing, tattooing, use of illicit intravenous drugs, and pet ownership, various outdoor leisure activities, such as gardening, camping, spelunking, and hunting, and traveling to endemic areas are associated with an increased risk of IFIs. Finally, some modern diet habits dictate the consumption of food or herbal products harboring pathogenic fungi or fungal toxins, which may cause IFIs in susceptible individuals.

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Epidemic of Pulmonary Blastomycosis (Namekagon Fever) in Wisconsin Canoeists

Cited by 70 publications

References 6 publications

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection Site

MAJOR ARTICLE: Cutaneous Inoculation Blastomycosis

Occupation, Lifestyle, Diet, and Invasive Fungal Infections

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