Epidemiological and Clinical Features of a Large Blastomycosis Outbreak at a Paper Mill in Michigan
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Le résumé fourni par la source
BACKGROUND: Blastomycosis is an environmentally acquired fungal infection that can result in severe pulmonary illness and high hospitalization rates. In 2023, a blastomycosis outbreak was detected among workers at a paper mill in Delta County, Michigan. METHODS: We included patients with clinical and laboratory evidence of blastomycosis who had spent ≥40 hours in Delta County since 1 September 2022 and had illness onset 1 December 2022-1 July 2023. We assessed epidemiological and clinical features of patients and evaluated factors associated with hospitalization. We performed whole-genome sequencing to characterize genetic relatedness of clinical isolates from 8 patients. RESULTS: In total, 131 patients were identified; all had worked at or visited the mill. Sixteen patients (12%) were hospitalized; 1 died. Compared with nonhospitalized patients, more hospitalized patients had diabetes (P = .03) and urine antigen titers above the lower limit of quantification (P < .001). Hospitalized patients were also more likely to have had ≥1 healthcare visits before receiving a blastomycosis diagnostic test (P = .02) and to have been treated with antibiotics prior to antifungal prescription (P = .001). All sequenced isolates were identified as Blastomyces gilchristii and clustered into a distinct outbreak cluster. CONCLUSIONS: This was the largest documented blastomycosis outbreak in the United States. Epidemiologic evidence indicated exposures occurred at or near the mill, and genomic findings suggested a common exposure source. Patients with diabetes may have increased risk of hospitalization, and elevated urine antigen titers could indicate greater disease severity. Early suspicion of blastomycosis may prompt earlier diagnosis and treatment, potentially reducing unnecessary antibiotic prescriptions and improving patient outcomes.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Epidemiological and Clinical Features of a Large Blastomycosis Outbreak at a Paper Mill in Michigan
- Date Crossref
- 18/10/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Centers for Disease Control and Prevention pays non établi dans la noticeOrganisme public
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Epidemic Intelligence Service pays non établi dans la noticeOrganisme public
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Michigan Department of Health and Human Services pays non établi dans la noticeOrganisme public
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National Institute for Occupational Safety and Health Centers for Disease Control and Prevention pays non établi dans la noticeStructure de recherche
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Office of the Director pays non établi dans la noticeInstitution
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The Centers pays non établi dans la noticeOrganisation à but non lucratif
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Mycotic Diseases Branch pays non établi dans la noticeInstitution
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Public Health Delta & Menominee Counties pays non établi dans la noticeInstitution
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Field Assignments Branch pays non établi dans la noticeInstitution
Centers for Disease Control and Prevention, Epidemic Intelligence Service et Michigan Department of Health and Human Services, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.