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Recurrent urban histoplasmosis, Indianapolis, Indiana, 1980-1981.

W F Schlech, L J Wheat, J L Ho

    American Journal of Epidemiology
    |September 1, 1983
    PubMed
    Summary

    An outbreak of acute histoplasmosis in Indianapolis was linked to construction activities. Excavation at a university campus likely caused the increased disease incidence in late 1980.

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    Area of Science:

    • Epidemiology
    • Infectious Diseases
    • Public Health

    Background:

    • Informal surveillance in Indianapolis identified a surge in acute histoplasmosis cases in late 1980.
    • Fifty-one cases were identified through hospital, emergency room, and serologic records.

    Purpose of the Study:

    • To investigate the cause of the increased acute histoplasmosis activity.
    • To identify the source and transmission routes of the outbreak.

    Main Methods:

    • A retrospective case-control study was conducted.
    • Investigated associations between disease onset and location, specifically the Indiana University-Purdue University campus.
    • Utilized skin testing and a new radioimmunoassay for histoplasmal immunoglobulin M antibodies.

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    Main Results:

    • A significant association was found between acute histoplasmosis and proximity to the Indiana University-Purdue University campus (p = 0.015).
    • Excavation for a new natatorium on campus was identified as the probable source of infection.
    • Serosurveys and skin tests supported the link between campus exposure and infection (p < 0.05).

    Conclusions:

    • Construction-related excavation activities, particularly at the university campus, were the likely cause of the histoplasmosis outbreak.
    • Public health surveillance and targeted serologic testing were effective in identifying the outbreak's source and scope.