Blastomyces Urine Antigen Testing for Active Case Identification During a Blastomycosis Outbreak

Details

• Journal Article:
  Emerging Infectious Diseases
• Personal Author:
  O'Connor, Allyson W. ; Hennessee, Ian ; Callaway, Perri C. ; Stanton, Marcia L. ; Liang, Xiaoming ; Park, Ju-Hyeong ; LeBouf, Ryan ; Bailey, Rachel L. ; Reik, Rebecca ; Stobierski, Mary G. ; Snyder, Michael ; Yin, Robert ; Toda, Mitsuru ; Cox-Ganser, Jean M. ; Hines, Stella E.
• Description:
  Blastomyces urine antigen testing is a sensitive blastomycosis diagnostic method, but its utility for active case identification during outbreaks is unknown. We evaluated urine antigen testing for identifying blastomycosis cases during a 2023 outbreak at a Michigan, USA, paper mill and assessed demographic and clinical factors associated with test positivity. Approximately 2 months after the outbreak was recognized, we collected work and health information for 603 employees; 95% (n = 578) underwent urine antigen testing and 9% (n = 52) tested positive, including 25 previously undetected cases. Blastomycosis-like symptoms were associated with test positivity (p<0.001), but 10% of employees with positive results were asymptomatic. Recent hospitalization for blastomycosis was associated with test positivity (p = 0.02) and higher antigen levels. Further research into urine antigen testing is needed clarify its suitability for detecting mild and asymptomatic infections during outbreak investigations. Urine antigen testing had high acceptability among employees and effectively identified additional cases.
• Subjects:
  Blastomycosis Mycoses Occupational Health Safety
• Keywords:
  Blastomycosis; Diagnostic tests; Urine; Antigens; Paper mills; Infectious diseases; Fungal diseases; Clinical diagnosis; Demographic characteristics
• Source:
  Emerg Infect Dis 2026 Mar; 32(3):360-367
• ISSN:
  1080-6040
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  West Virginia ; Georgia ; Michigan ; Philadelphia Region [OSHA] ; Atlanta Region [OSHA] ; Chicago Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  8 pdf pages
• Volume:
  32
• Issue:
  3
• NIOSHTIC Number:
  nn:20071462
• Contact Point Address:
  Mitsuru Toda, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop H24-11, Atlanta, GA 30329-4018, USA
• Email:
  nrk7@cdc.gov
• Federal Fiscal Year:
  2026
• Peer Reviewed:
  True
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d0a0bd0bd813ee8c4b317d2e34f4adedde3bfa105c4a07b4e477621f2e3ff2a87aa4ec66b5cec082ba5af98a038a05dfd81ee7f428a786a29f50abc6286efd22
• Download URL:
  https://stacks.cdc.gov/view/cdc/259060/cdc_259060_DS1.pdf
• File Type:
  [PDF - 652.30 KB ]