Blastomycosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2]


Epidemiology and Demographics

Developed Countries

In the United States, blastomycosis is endemic in the Mississippi river and Ohio river basins and around the Great Lakes. The annual incidence is less than 1 case per 100,000 people in Mississippi, Louisiana, Kentucky, and Arkansas. The cases are greater in northern states such as Wisconsin, where from 1986 to 1995 there were 1.4 cases per 100,000 people.[1] . Outbreaks or epidemics are known to occur, in a period between 2005-2008 an outbreak was reported in Indianapolis, where 34 cases were diagnosed and coincided with the construction of highways in that area. [2] Another outbreak of 55 cases was reported in 2009-2010 in Wisconsin and a large proportion of cases(45%) was seen in the Hmong community, though the exact reason behind their predisposition was not known. This was the largest reported outbreak ever and showed clustering of cases in the neighborhood, which to an extent explains multifactorial environmental sources behind these outbreaks.[3]

In Canada, most cases of blastomycosis occur in northwestern Ontario, particularly around the Kenora, Ontario area. The moist, acidic soil in the surrounding woodland harbors the fungus. Recently, Quebac was identified as an area endemic for blastomycosis with an incidence of 0.133/100,000. [4]

International

Blastomycosis is distributed internationally; cases are sometimes reported from Africa.[5] Cases have also been reported from India, Middle east, Mexco, Central and South America. It was originally thought that the fungus affects middle-aged men who work outdoors, however the studies conducted on reported outbreaks do not show any predilection based on age, sex, race, occupation or season. It prefers to grow in warm, moist soil rich, in organic materials and exposure to soil seems to be the only common factor among patients.

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References

  1. "Blastomycosis--Wisconsin, 1986-1995". MMWR Morb. Mortal. Wkly. Rep. 45 (28): 601–3. 1996. PMID 8676851.
  2. Carlos, WG.; Rose, AS.; Wheat, LJ.; Norris, S.; Sarosi, GA.; Knox, KS.; Hage, CA. (2010). "Blastomycosis in indiana: digging up more cases". Chest. 138 (6): 1377–82. doi:10.1378/chest.10-0627. PMID 20558552. Unknown parameter |month= ignored (help)
  3. Roy, M.; Benedict, K.; Deak, E.; Kirby, MA.; McNiel, JT.; Sickler, CJ.; Eckardt, E.; Marx, RK.; Heffernan, RT. (2013). "A large community outbreak of blastomycosis in wisconsin with geographic and ethnic clustering". Clin Infect Dis. 57 (5): 655–62. doi:10.1093/cid/cit366. PMID 23735332. Unknown parameter |month= ignored (help)
  4. Litvinov, IV.; St-Germain, G.; Pelletier, R.; Paradis, M.; Sheppard, DC. (2013). "Endemic human blastomycosis in Quebec, Canada, 1988-2011". Epidemiol Infect. 141 (6): 1143–7. doi:10.1017/S0950268812001860. PMID 22929032. Unknown parameter |month= ignored (help)
  5. Alvarez G, Burns B, Desjardins M, Salahudeen S, AlRashidi F, Cameron D (2006). "Blastomycosis in a young African man presenting with a pleural effusion". Can Respir J. 13 (8): 441–4. PMID 17149463.
  6. "Public Health Image Library (PHIL)".

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