The Epidemiology of Blastomycosis

DiSalvo, Arthur F.

doi:10.1007/978-1-4615-3306-1_5

Cited by 22 publications

(12 citation statements)

References 61 publications

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“…However, Aspergillus fumigatus, an allergenic opportunistic fungal pathogen with spores similar in size to B. dermatitidis, is a well known constituent of compost bioaerosols. 30,31 When bioaerosols are produced through mechanical agitation of compost piles, studies demonstrate the numbers of A. fumigatus spores decline to background levels within 200 meters from the source, although the distance may be greater under certain atmospheric conditions. 28 These studies with A. fumigatus and the two previously reported blastomycosis outbreaks associated with airborne dust exposure suggest a potential hazard may exist within and near yard material collection, especially where pine tree litter is present, or composting facilities in areas endemic for blastomycosis.…”

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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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%

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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“…dermatitidis is a thermally dimorphic fungal pathogen with a wide geographic distribution, and it causes disease primarily in humans, dogs, and other mammals (1,3,4,6,8,20,21). B. dermatitidis resides in the environment as a saprophytic mold that forms infectious conidia that are aerosolized under the appropriate environmental conditions.…”

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confidence: 99%

Extracellular Calcium and Magnesium, but Not Iron, Are Needed for Optimal Growth ofBlastomyces dermatitidisYeast Form Cells In Vitro

Giles

Czuprynski

2004

Clin Vaccine Immunol

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In the present study, we demonstrate that the yeast form of Blastomyces dermatitidis can proliferate for short periods of time in the absence of ferric iron but not in the absence of calcium or magnesium. The results of this study shed light on the resistance of B. dermatitidis to chelating agents, such as deferoxamine, and may explain how B. dermatitidis resists the iron-binding activity of serum transferrin.

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“…10 Among adults, CAP is considered a disease of the elderly with equal sex and racial distribution, although good community-based data is lacking. 35,36 Prior studies have inconsistently suggested an increased incidence of blastomycosis in blacks and certain other nonwhite persons, 37,38 and higher age-adjusted mortality rates in these groups. 39 Recent studies have suggested differing clinical features of blastomycosis among different human genetic and ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

“…As reviewed elsewhere in this issue, 24 many studies, but not all, 42 found outdoor occupations made up a minority of blastomycosis cases. There have been reports of blastomycosis cases in autoworkers based on short case series or case studies, 37,[43][44][45] but no systematic investigation of this connection. Whether auto-related businesses afford opportunities for workplace exposure to Blastomyces, or whether this association simply reflects persons who disproportionately encounter the fungus during home or recreational activities, is unclear.…”

Section: Discussionmentioning

confidence: 99%