FW: PRO/EDR> Histoplasmosis - USA: (IL) prison

[Maffei, Joanne]

-----Original Message-----
From: promed-ed...@promedmail.org [mailto:promed-ed...@promedmail.org] On Behalf Of prome...@promedmail.org
Sent: Friday, September 20, 2013 11:36 AM
To: pro...@promedmail.chip.org; prome...@promedmail.chip.org
Subject: PRO/EDR> Histoplasmosis - USA: (IL) prison


HISTOPLASMOSIS - USA: (ILLINOIS) PRISON
***************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases <http://www.isid.org>

Date: Fri 13 Sep 2013
Source: WREX [edited]
<http://www.wrex.com/story/23425310/2013/09/13/illness-at-eastern-illinois-prison-likely-caused-by-fungus>


Officials with the CDC believe an illness at the Danville prison [Illinois] was likely caused by fungus, not a virus. CDC experts are running tests at the prison, where inmates began falling ill in late August 2013. About 100 of the prison's 1800 inmates have been affected.

The Illinois Department of Public Health believes the illness has been caused by [_Histoplasma capsulatum_], a fungus found in some Illinois soil that can be inhaled. However, some false-positive tests initially led authorities to believe the illness was caused by the adenovirus.

Department of Corrections spokesman Tom Shaer says the illness is not contagious and the prison has not seen a new case in a week.

[Byline: Samantha Jeffreys]

--
Communicated by:
ProMED-mail
<pro...@promedmail.org>

[It is not stated in the posting whether any construction or demolition was done in or around the prison, which could have produced aerosolization of the infectious spore form of this pathogen. With a clinical attack rate of about 5 percent and the knowledge that most cases of acute histoplasmosis are asymptomatic, it is likely that most of the prison population became infected.

As a review, the following was obtained from Medscape
(<http://emedicine.medscape.com/article/299054-overview#showall>):

_Histoplasma capsulatum_ is a dimorphic fungus that remains in a mycelial form at ambient temperatures and grows as yeast at body temperature in mammals. Infection causes histoplasmosis. Although the fungus that causes histoplasmosis can be found in temperate climates throughout the world, it is endemic to the Ohio, Missouri, and Mississippi River valleys in the United States. Internationally, the fungus is predominantly found in river valleys in North and Central America, eastern and southern Europe, and parts of Africa, eastern Asia, and Australia.

The soil in areas endemic for histoplasmosis provides an acidic damp environment with high organic content that is good for mycelial growth. Highly infectious soil is found near areas inhabited by bats and birds. Birds cannot be infected by the fungus and do not transmit the disease; however, bird excretions contaminate the soil, thereby enriching the growth medium for the mycelium. In contrast, bats can become infected, and they transmit histoplasmosis through droppings.
Contaminated soil can be potentially infectious for years. Outbreaks of histoplasmosis have been associated with construction and renovation activities that disrupt contaminated soil. In addition, travelers to endemic areas are at risk for histoplasmosis because airborne spores can travel hundreds of feet.

Most individuals with histoplasmosis are asymptomatic. Those who develop clinical manifestations are usually immunocompromised or are exposed to a high quantity of inoculum. _Histoplasma_ species may remain latent in healed granulomas and recur, if there is impairment of cell-mediated immunity.

Approximately 90 per cent of patients are asymptomatic. If symptoms develop, onset occurs 3-14 days after exposure. Fever, headache, malaise, myalgia, abdominal pain, and chills are common symptoms; usually, histoplasmosis is self-limited. Individuals exposed to a large inoculum may develop severe dyspnea resulting from diffuse pulmonary involvement. Joint pain and skin lesions occur in 5-6 per cent of patients, mostly in females. Enlarged hilar [the hilum is part of a gland or organ through which ducts, nerves, or blood vessels enter and leave] and mediastinal lymph nodes are present in 5-10 per cent of patients. Cough, hemoptysis, dyspnea, and/or chest pain may be present and are related to the degree of compression on the pulmonary airway and circulation. Paratracheal involvement may cause cough or dyspnea because of compression on the trachea or bronchi." - Mod.LL

A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/r/8vaJ>.]

[see also:
Histoplasmosis, researchers - UK: ex Uganda, 2011 20130311.1581417
2012
----
Histoplasmosis - USA (02): travelers, comment 20120922.1304707 Histoplasmosis - USA: (NE) day camp attendees 20120920.1303165
2011
----
Histoplasmosis, researchers - UK: ex Uganda, alert 20110908.2738
2008
----
Histoplasmosis, travelers - USA ex El Salvador (02): background
20081222.4030
Histoplasmosis, travelers - USA ex El Salvador 20081219.3994
2006
----
Histoplasmosis, researchers - Italy ex Ecuador: alert 20060825.2399
2001
----
Histoplasmosis - Mexico (Acapulco) 20011016.2547] .................................................ll/mj/ml
*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held responsible for errors or omissions or held liable for any damages incurred as a result of use or reliance upon posted or archived material.
************************************************************
Donate to ProMED-mail. Details available at:
<http://www.isid.org/donate/>
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: pro...@promedmail.org (NOT to an individual moderator). If you do not give your full name name and affiliation, it may not be posted. You may unsub- scribe at <http://ww4.isid.org/promedmail/subscribe.php>.
For assistance from a human being, send mail to:
<postm...@promedmail.org>.
############################################################
############################################################

List-Unsubscribe: http://ww4.isid.org/promedmail/subscribe.php