Post by Sidney on Apr 16, 2010 16:35:34 GMT -5
tinyurl.com/y27a4cb
AN OUTBREAK OF HUMAN BLASTOMYCOSIS: THE EPIDEMIOLOGY OF BLASTOMYCOSIS IN THE KENORA CATCHMENT REGION OF ONTARIO, CANADA*
Introduction
Blastomycosis is a systemic fungal infection caused by the organism Blastomyces dermatitidis. It has a highly variable clinical spectrum and can cause acute pneumonia-like illness or chronic pulmonary disease; in a disseminated form it can have cutaneous manifestations, less commonly involve the genitourinary tract, bone or even the central nervous system, and in rare instances lead to death(1,2).
The incidence of blastomycosis has not been reliably reported because it is not nationally reportable in Canada or the United States, although it is reportable in Wisconsin(1,3). The ecological niche of blastomycosis has become better defined, but is not yet fully understood because of the great difficulty in isolating the organism from the environment. Outbreak studies have implicated the building of a hunting lodge, proximity to a construction site, raccoon hunting, exposure to a beaver lodge, and activities by riverbanks as sources of exposure(4-7). So far, favourable characteristics are thought to be warm moist soil, slightly acidic pH, animal excrement, organic debris and adjacency to waterways such as lakes or rivers (3,5,8). However, because of the difficulty in isolating the organism from the soil, the clustering of cases should be used to build upon the growing body of information.
Blastomycosis is referred to as one of the more important endemic mycoses in North America, but its epidemiology is poorly understood(9). Central Canada has long since been identified as part of the endemic areas, but there have been few studies originating from this region. From 1970 to 1981, the Central Public Health Laboratory in Toronto, Ontario, confirmed 38 cases of blastomycosis(4). Since then, 16 cases were reported in Ontario from 1982 until 1989, when blastomycosis was removed from the list of diseases reportable under Ontario regulations(10). Recently, there has been a resurgence of interest in blastomycosis in Ontario. In the Kenora, Keewatin, Jaffray Mellick tri-municipal area, and the surrounding reserves in the northwestern region of Ontario, there has been an apparent increase in blastomycosis incidence. This study attempts to describe the epidemiology of blastomycosis in this area, to estimate and compare the incidence with that of other endemic areas, and to contribute to the growing body of information on blastomycosis
AN OUTBREAK OF HUMAN BLASTOMYCOSIS: THE EPIDEMIOLOGY OF BLASTOMYCOSIS IN THE KENORA CATCHMENT REGION OF ONTARIO, CANADA*
Introduction
Blastomycosis is a systemic fungal infection caused by the organism Blastomyces dermatitidis. It has a highly variable clinical spectrum and can cause acute pneumonia-like illness or chronic pulmonary disease; in a disseminated form it can have cutaneous manifestations, less commonly involve the genitourinary tract, bone or even the central nervous system, and in rare instances lead to death(1,2).
The incidence of blastomycosis has not been reliably reported because it is not nationally reportable in Canada or the United States, although it is reportable in Wisconsin(1,3). The ecological niche of blastomycosis has become better defined, but is not yet fully understood because of the great difficulty in isolating the organism from the environment. Outbreak studies have implicated the building of a hunting lodge, proximity to a construction site, raccoon hunting, exposure to a beaver lodge, and activities by riverbanks as sources of exposure(4-7). So far, favourable characteristics are thought to be warm moist soil, slightly acidic pH, animal excrement, organic debris and adjacency to waterways such as lakes or rivers (3,5,8). However, because of the difficulty in isolating the organism from the soil, the clustering of cases should be used to build upon the growing body of information.
Blastomycosis is referred to as one of the more important endemic mycoses in North America, but its epidemiology is poorly understood(9). Central Canada has long since been identified as part of the endemic areas, but there have been few studies originating from this region. From 1970 to 1981, the Central Public Health Laboratory in Toronto, Ontario, confirmed 38 cases of blastomycosis(4). Since then, 16 cases were reported in Ontario from 1982 until 1989, when blastomycosis was removed from the list of diseases reportable under Ontario regulations(10). Recently, there has been a resurgence of interest in blastomycosis in Ontario. In the Kenora, Keewatin, Jaffray Mellick tri-municipal area, and the surrounding reserves in the northwestern region of Ontario, there has been an apparent increase in blastomycosis incidence. This study attempts to describe the epidemiology of blastomycosis in this area, to estimate and compare the incidence with that of other endemic areas, and to contribute to the growing body of information on blastomycosis