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Histoplasmosis Outbreaks in Brazil: Lessons to Learn About Preventing Exposure
Bernardo Tenório Guerra1, Fernando Almeida-Silva2, Rodrigo Almeida-Paes2
1Núcleo de Medicina Tropical, Faculdade de Medicina, Universidade de Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brasília, DF, CEP 70910-900, Brazil.
Abstract:
Histoplasmosis is considered the most common invasive opportunistic fungal disease in the Americas, with outbreaks and micro-epidemics reported for over 80 years. In Brazil, this disease has been described since 1946, reaching a remarkable incidence in the population, especially during the HIV-AIDS pandemic. In this study, published and unpublished outbreaks and micro-epidemics of histoplasmosis in Brazil were revisited by accessing different database sources and evaluating epidemiological and clinical features. We have found reports spanning 1946-2017, across 10 Brazilian states and with involvement of 370 humans and 2 dogs, and 13 disseminated cases and 3 deaths were reported. Rio de Janeiro had the largest number of outbreaks (n = 20/40; 50%) reported in this study. The majority of outbreaks and micro-epidemics was reported in caves (n = 21/40; 52.5%), followed by reports in abandoned/deactivated sites (n = 6/40; 15%), mines (n = 5/40; 12.5%), chicken coops (n = 4/40; 10%). Histoplasmosis is a serious health issue in Brazil considering the attractive and growing market of ecotourism throughout more than 7000 caves, and all levels of poultry farming activity are important to raise awareness about how dangerous this neglected disease can be and establish ways to decrease exposure to contaminated environmental sources through adequate preventive measures.
Insights
Histoplasmosis, a common fungal infection in the Americas, has been documented in Brazil since 1946. This study revisits outbreaks, highlighting caves and poultry farms as high-risk environments requiring preventive measures.
Area of Science:
- * Infectious Diseases
- * Mycology
- * Epidemiology
Background:
- * Histoplasmosis is the most frequent invasive opportunistic fungal disease in the Americas.
- * Brazil has reported cases since 1946, with increased incidence during the HIV-AIDS pandemic.
- * Outbreaks and micro-epidemics have been documented for over 80 years.
Purpose of the Study:
- * To revisit and analyze published and unpublished histoplasmosis outbreaks and micro-epidemics in Brazil.
- * To evaluate the epidemiological and clinical features of these events.
- * To raise awareness about histoplasmosis risks in Brazil, particularly concerning ecotourism and poultry farming.
Main Methods:
- * Review of published and unpublished data on histoplasmosis outbreaks and micro-epidemics in Brazil.
- * Accessing diverse database sources for comprehensive data collection.
- * Evaluation of epidemiological and clinical characteristics of reported cases.
Main Results:
- * Data spanning from 1946 to 2017 across 10 Brazilian states were analyzed.
- * A total of 370 human cases, 2 canine cases, 13 disseminated infections, and 3 deaths were reported.
- * The majority of outbreaks occurred in caves (52.5%), followed by abandoned sites (15%), mines (12.5%), and chicken coops (10%). Rio de Janeiro reported the most outbreaks (50%).
Conclusions:
- * Histoplasmosis remains a significant public health concern in Brazil.
- * The growing ecotourism market (especially caves) and poultry farming necessitate increased awareness and preventive strategies.
- * Reducing exposure to contaminated environmental sources is crucial for controlling histoplasmosis transmission.
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