Sporotrichosis in Himachal Pradesh (north India)

Sporotrichosis is being increasingly reported from a particular area of Himachal Pradesh, a state in north-west India. A skin-test survey was conducted using sporotrichin and peptido-rhamnomannan antigen among the population in the villages where 2 or more cases of sporotrichosis had been reported and results were compared with those for villages of the same where no case of sporotrichosis had been reported. The study was helped by local doctors, leaders and patients who were cured of sporotrichosis. The delayed-hypersensitivity positivity rates were significantly higher in case villages (range 22.9-40.0%) compared to control area (range 6.5-7.6%). Analysis by age showed that positivity rate increased with increase in age for both sexes. Analysis by occupation showed higher skin-test positivity in populations engaged in horticulture, nursery work, gardening, woodwork (43.2%) and farming (33.9%). The case villages have lower temperature and higher rainfall than the control villages. During the 1-year study period (1996-97), 25 cases of sporotrichosis were diagnosed: 16 cases were referred by doctors from the local area and 9 were from cases suspected during the skin-test survey. This study identifies Kangra district and adjoining areas in Himachal Pradesh as an endemic region for sporotrichosis and highlights the need for evaluation of geo-climatically similar areas.