Outbreak of Severe Histoplasmosis Among Tunnel Workers—Dominican Republic, 2015

Armstrong, Paige A.; Beard, John D.; Bonilla, Luis; Arboleda, Nelson B.; Lindsley, Mark D.; Chae, Sae-Rom; Castillo, Delia Iliana Tapia; Nunez, R Consuegra; Chiller, Tom; Perio, Marie A. de; Pimentel, Raquel; Vallabhaneni, Snigdha

doi:10.1093/cid/cix1067

Cited by 25 publications

(24 citation statements)

References 14 publications

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“…In Brazil, the introduction of such testing led to a 53.8% increase in diagnostic yield [ 40 ]. Scattered cases of histoplasmosis have been identified throughout the Caribbean islands including outbreaks in the Dominican Republic and Cuba with endemicity recognized in Jamaica [ 41 – 44 ]. Histoplasmin skin test positivity rates as high as 42% in Trinidad and Tobago suggest that Caribbean cases may be under-recognized as well [ 45 ].…”

Section: Methodsmentioning

confidence: 99%

Re-drawing the Maps for Endemic Mycoses

et al. 2020

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Endemic mycoses such as histoplasmosis, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, and talaromycosis are well-known causes of focal and systemic disease within specific geographic areas of known endemicity. However, over the past few decades, there have been increasingly frequent reports of infections due to endemic fungi in areas previously thought to be “non-endemic.” There are numerous potential reasons for this shift such as increased use of immune suppressive medications, improved diagnostic tests, increased disease recognition, and global factors such as migration, increased travel, and climate change. Regardless of the causes, it has become evident that our previous understanding of endemic regions for these fungal diseases needs to evolve. The epidemiology of the newly described Emergomyces is incomplete; our understanding of it continues to evolve. This review will focus on the evidence underlying the established areas of endemicity for these mycoses as well as new data and reports from medical literature that support the re-thinking these geographic boundaries. Updating the endemic fungi maps would inform clinical practice and global surveillance of these diseases.

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Section: Methodsmentioning

confidence: 99%

Re-drawing the Maps for Endemic Mycoses

et al. 2020

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“…Bats are not only found in caves but can be present in tunnels. A recent outbreak in the Dominican Republic highlighted this association [ 24 ]. A dam had five associated tunnels in which bats had been roosting, and a company was contracted to remove the guano, which reached up to one meter deep from the tunnels.…”

Section: A Spelunker’s Concernmentioning

confidence: 99%

Outbreaks of histoplasmosis: The spores set sail

Deepe

2018

PLoS Pathog

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“…30 men developed histoplasmosis, of whom 28 were hospitalised and three died, a case-fatality rate approximately ten times higher than is typically described in the USA; the high hospitalisation and mortality rates were probably related to a large inoculum within an enclosed space. 29 Adequate respiratory protection was not used. Low awareness about histoplasmosis risk in this area contributed to the absence of adequate workplace precautions.…”

Section: Community-acquired Fungal Disease Outbreaksmentioning

confidence: 99%

Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks

Benedict

Richardson

Vallabhaneni

et al. 2017

The Lancet Infectious Diseases

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105

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Several high-profile outbreaks have drawn attention to invasive fungal infections (IFIs) as an increasingly important public health problem. IFI outbreaks are caused by many different fungal pathogens and are associated with numerous settings and sources. In the community, IFI outbreaks often occur among people without predisposing medical conditions and are frequently precipitated by environmental disruption. Health-care-associated IFI outbreaks have been linked to suboptimal hospital environmental conditions, transmission via health-care workers’ hands, contaminated medical products, and transplantation of infected organs. Outbreak investigations provide important insights into the epidemiology of IFIs, uncover risk factors for infection, and identify opportunities for preventing similar events in the future. Well recognised challenges with IFI outbreak recognition, response, and prevention include the need for improved rapid diagnostic methods, the absence of routine surveillance for most IFIs, adherence to infection control practices, and health-care provider awareness. Additionally, IFI outbreak investigations have revealed several emerging issues, including new populations at risk because of travel or relocation, occupation, or immunosuppression; fungal pathogens appearing in geographical areas in which they have not been previously recognised; and contaminated compounded medications. This report highlights notable IFI outbreaks in the past decade, with an emphasis on these emerging challenges in the USA.

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Outbreak of Severe Histoplasmosis Among Tunnel Workers—Dominican Republic, 2015

Cited by 25 publications

References 14 publications

Re-drawing the Maps for Endemic Mycoses

Re-drawing the Maps for Endemic Mycoses

Outbreaks of histoplasmosis: The spores set sail

Emerging issues, challenges, and changing epidemiology of fungal disease outbreaks

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