| Clinical
Features |
Symptomatic infection (50% of cases)
usually presents as a flu-like illness with fever, chills,
productive cough, myalgia, arthralgia and pleuritic chest
pain. Some patients fail to recover and develop chronic pulmonary
infection or widespread disseminated infection (affecting
the skin, bones, and genitourinary tract). Occasionally affects
the meninges. |
| Etiologic
Agent |
Blastomyces dermatitidis. |
| Reservoir |
Moist soil enriched with decomposing
organic debris. Endemic in parts of the south-central, south-eastern
and mid-western United States. Microfoci in Central and South
America and parts of Africa. |
| Incidence |
1-2 cases per 100,000 population
in areas with endemic disease. |
| Sequelae |
Permanent lung damage with chronic
disease. Mortality rate is about 5%. |
| Transmission |
Inhalation of airborne conidia (spores)
after disturbance of contaminated soil. |
| Risk
Groups |
Persons in areas with endemic disease
with exposures to wooded sites (e.g., farmers, forestry workers,
hunters, and campers). |
| Surveillance |
Reportable in a few states in areas
with endemic disease. No national surveillance exists. |
| Challenges |
Improving understanding of sources
and routes of transmission from the environment. Developing
more sensitive and specific tests for diagnosis. |
|
December 2003
|
