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Published on: February 14, 2011

A winter outbreak of acute histoplasmosis in northern Michigan

R J Waldman, A C England, R Tauxe

    American Journal of Epidemiology
    |January 1, 1983
    PubMed

    Insights

    An outbreak of acute pulmonary disease at a Michigan quarry was caused by Histoplasma capsulatum. Exposure occurred via a contaminated pulley stored in a bird nesting area, leading to widespread infection among employees.

    Area of Science:

    • Environmental Health
    • Infectious Diseases
    • Mycology

    Background:

    • An outbreak of acute pulmonary disease affected 138 employees at a Michigan limestone quarry in January 1980.
    • The disease presented as a significant public health concern within the industrial setting.

    Purpose of the Study:

    • To identify the causative agent and source of the acute pulmonary disease outbreak.
    • To determine the exposure pathway and risk factors associated with the illness.

    Main Methods:

    • Epidemiological investigation including case finding and risk factor analysis.
    • Environmental sampling to identify potential etiological agents.
    • Microbiological analysis of environmental samples and patient sputum.
    • Serological testing for confirmation of diagnosis.

    Main Results:

    • A vessel repair building was identified as the primary exposure site (relative risk = 5.8).
    • Exposure on January 10 was significantly associated with illness (relative risk = 2.4).
    • Histoplasma capsulatum was isolated from a pulley, a bird nesting area, and patient sputum, confirming the etiological agent.

    Conclusions:

    • The outbreak was attributed to acute pulmonary histoplasmosis.
    • Contaminated pulley, stored in a ring-billed gull nesting area, served as the source of Histoplasma capsulatum exposure.
    • Prompt diagnosis and identification of the source were crucial in managing the outbreak.

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