Outbreak of Severe Histoplasmosis

Joanna Elinor
1103010
Definición
Histoplasmosis is a fungal
infection associated with
exposure to bat guano.

An outbreak of an unknown
severe febrile illness
occurred among tunnel
workers in the Dominican
Republic, and resulted in
several deaths.

2
“ An outbreak of an
unknown severe febrile
illness occurred among
tunnel workers in the
Dominican Republic, and
resulted in several deaths.
3
methods

⊹ Descriptive Epidemiology and Cohort Study

⊹ Laboratory Analysis
⊹ Statistical Analysis
⊹ Ethics Approval

4
Symptoms

5
Laboratory analysis

6
Entrance To a tunnel associated with the outbreak
7
 results
⊹ Background on Tunnel ⊹ Clinical Presentation
Work ⊹ Laboratory Analysis
⊹ Worker Interviews ⊹ Cohort Study
8
Características de los trabajadores (n=36)

For the 3 workers already deceased at the time of the

interview, we spoke with an immediate family member.
10
 Discussion
Sporadic cases of Clinicians in the DR Aside from the delayed
histoplasmosis were largely diagnosis and treatment,
attributed to unfamiliar with probable exposure to
exposure in the DR histoplasmosis and high H. capsulatum
have been laboratories did not inocula in the tunnels,
diagnosed in have the capacity to coupled with poor
travelers return- ing definitively diagnose ventilation and
to their countries of the disease. inadequate occupational
origin precautions, contributed
to the outbreak’s
severity. 11
 Our study had
several limitations
that may have
interfered with our
ability to detect
associations.

12
Thanks!

13
references
Richardson M, Warnock D. Histoplasmosis. In: Fungal infection: diagnosis and management.
Oxford, UK: Wiley-Blackwell, 2012:304–21.

Handzel S, Jessamine AG. Imported histoplasmosis from Puerto Rico. Can J Public Health 1975;
66:393–5.

Theel ES, Harring JA, Dababneh AS, Rollins LO, Bestrom JE, Jespersen DJ. Reevaluation of
commercial reagents for detection of Histoplasma capsulatum antigen in urine. J Clin Microbiol
2015; 53:1198–203.

Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr 1974;
9:716–23.

Howe CJ, Cole SR, Westreich DJ, Greenland S, Napravnik S, Eron JJ Jr. Splines for trend analysis
and continuous confounder control. Epidemiology 2011; 22:874–5.

Calanni LM, Pérez RA, Brasili S, et al. Outbreak of histoplasmosis in province of

Neuquén, Patagonia Argentina. Rev Iberoam Micol 2013; 30:193–9.
14