<i>Cryptococcus gattii</i>Risk for Tourists Visiting Vancouver Island, Canada

Lindberg, Jens; Hagen, Ferry; Laursen, Alex Lund; Stenderup, Jørgen; Boekhout, Teun

doi:10.3201/eid1301.060945

Cited by 53 publications

(37 citation statements)

References 4 publications

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“…A clear need exists for retrospective studies of patients to determine host risk factors as well as for prospective case studies to determine efficacy of treatments. The number of cases continuing to occur on Vancouver Island (and among tourists [46]) would allow this type of investigation.…”

Section: Clinical Considerationsmentioning

confidence: 99%

The emergence of Cryptococcus gattii in British Columbia and the Pacific Northwest

Bartlett

Kidd²,

Kronstad

2008

Curr Infect Dis Rep

110

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An unprecedented emergence of cryptococcal infections in animals and otherwise healthy humans was recognized in 1999 on the east coast of Vancouver Island, British Columbia. Unexpectedly, these infections were caused by Cryptococcus gattii, a species closely related to the AIDS-associated fungal pathogen Cryptococcus neoformans. Human cases have continued over the past 8 years and now total approximately 170 with eight deaths. Extensive environmental sampling, coupled with detailed molecular typing of isolates, revealed areas of permanent and transient colonization with primarily three genotypes of the fungus. C. gattii was found in air, soil, water, and in association with numerous tree species. Importantly, there is solid evidence for human-mediated dispersal of the pathogen, and C. gattii has now been detected in the environment on the mainland of British Columbia and in the Pacific Northwest. Associated animal and human cases are now being reported and further spread of the pathogen may be inevitable.

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Section: Clinical Considerationsmentioning

confidence: 99%

The emergence of Cryptococcus gattii in British Columbia and the Pacific Northwest

Bartlett

Kidd²,

Kronstad

2008

Curr Infect Dis Rep

110

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“…In addition to the North Carolina patient, there have been at least three cases of C. gattii infection in European tourists who visited VI and later presented in their home country with C. gattii cryptococcosis with the VI-specific VGIIa genotype [33,36,38]. Two of the European patients had no predisposing risk factors to infection; one had an 8-month history of corticosteroid use [38].…”

Section: Travel-associated Infectionmentioning

confidence: 96%

“…These situations indicate that travel can be an important component of patient history when cryptococcal infection is suspected in an atypical patient. Interestingly, these infections helped define the known extremes of incubation for C. gattii infection, as one patient became ill 6 weeks after exposure [33] and another became ill 13 months after exposure [36]. It is recommended that clinicians determine a travel history for patients with symptoms of cryptococcal infection.…”

Section: Travel-associated Infectionmentioning

confidence: 97%

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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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“…In 1999, C. gattii emerged on the east coast of Vancouver Island (VI), British Columbia (BC), Canada (2), and is now considered endemic in the environment (3,4), affecting human (5) and animal populations (6). Travel histories of patients have been used to monitor fungal spread (5) and to estimate the incubation period of this disease (7,8).…”

mentioning

confidence: 99%