A Large Histoplasmosis Outbreak Among High School Students in Indiana, 2001

Details

• Personal Author:
  Brandt ME ; Chamany S ; Fleming JW ; Hajjeh RA ; Howell JF ; Iqbal NJ ; Lenhart, Steven W. ; Lindsley MD ; Mirza SA ; Mortimer, Vincent D. ; Phelan MA ; Warnock DW ; Wheat LJ
• Description:
  Background: A histoplasmosis outbreak occurred in an Indiana high school in November-December 2001. Methods: To describe the risk factors for this outbreak, we conducted a cohort study of all available students and staff (N = 682) and an environmental investigation. Results: Of the 523 (77%) persons who displayed serologic evidence of recent Histoplasma capsulatum infection, 355 (68%) developed symptoms consistent with acute pulmonary histoplasmosis. Rototilling of soil in a school courtyard known to be a bird roosting site had been performed during school hours on November 12, 2001, 14 days before both the peak of the onset of illness and a rise in student absenteeism. Being a student (odds ratio, 3.1; 95% confidence interval, 2.2-5.0) and being a student in a classroom near the courtyard during the rototilling (odds ratio, 3.1; 95% confidence interval, 1.8-5.2) were independently associated with infection and symptomatic illness. H. capsulatum was isolated from environmental samples, including soil from the courtyard and dust collected from a filter of a heating, ventilating and air-conditioning system. Conclusions: Soil-disrupting activities within a school courtyard caused the largest outbreak to date of histoplasmosis among adolescents. Improved efforts are needed to educate the community in endemic areas about histoplasmosis to prevent the occurrence of such outbreaks in the future. In addition, increased awareness among health care providers of this disease would facilitate appropriate diagnosis and treatment. [Description provided by NIOSH]
• Subjects:
  Agriculture Hypersensitivity Insecticides Occupational Health Organophosphates Safety Urine
• Keywords:
  Agricultural-chemicals Agricultural-industry Chemical-hypersensitivity Children Insecticide-poisoning Organo-phosphorus-pesticides Urinalysis Urine-chemistry
• ISSN:
  0891-3668
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; Indiana ; Ohio ; OSHA Region 4 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• NIOSHTIC Number:
  nn:20031512
• Citation:
  Pediatr Infect Dis J 2004 Oct; 23(10):909-914
• Contact Point Address:
  Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, 1600 Clifton Road, MS C09, Atlanta, GA 30333
• Email:
  jtm7@cdc.gov
• Federal Fiscal Year:
  2005
• Peer Reviewed:
  True
• Source Full Name:
  Pediatric Infectious Disease Journal
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3a0d68695ee370e85147db36fea931fdd7aa213b9db6cc3a2e5da916d5c9ae057929a92b7cc162740048062ec1921e0ccb81838ab38b7c00a6be746da5acbba7
• Download URL:
  https://stacks.cdc.gov/view/cdc/185777/cdc_185777_DS1.pdf
• File Type:
  [PDF - 570.27 KB ]