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Blastomycosis in Missouri: epidemiology and risk factors for endemic disease

Published online by Cambridge University Press:  07 October 2003

M. V. CANO ,
G. F. PONCE-DE-LEON ,
S. TIPPEN ,
M. D. LINDSLEY ,
M. WARWICK  and
R. A. HAJJEH
M. V. CANO
Affiliation:
Division of Bacterial and Mycotic Diseases, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA Current affiliations: M. V. Cano, Division of Global Migration and Quarantine, MS E-03, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Atlanta, GA 30333, USA. (Tel.: 404-498-1668; Fax: 404-498-1633; E-mail: [email protected]).
G. F. PONCE-DE-LEON
Affiliation:
Division of Bacterial and Mycotic Diseases, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA G. F. Ponce-de-leon, Office of the Director, MS C-12, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Atlanta, GA 30333, USA.
S. TIPPEN
Affiliation:
Missouri Department of Health, Jefferson City, MO, USA
M. D. LINDSLEY
Affiliation:
Division of Bacterial and Mycotic Diseases, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
M. WARWICK
Affiliation:
Missouri Department of Health, Jefferson City, MO, USA M. Warwick, The MITRE Corporation, MS W9 40, 7515 Colshire Drive, McLean, VA 22102, USA.
R. A. HAJJEH
Affiliation:
Division of Bacterial and Mycotic Diseases, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract

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Between 1992 and 1999, 93 cases of blastomycosis, including 25 laboratory confirmed cases, were identified in Missouri (annual incidence, 0·2/100000 population). Mississippi County in southeastern Missouri had the highest incidence (12/100000) with a much higher rate among blacks than whites in this county (43·2/100000). The mortality rate, 44% was also higher among blacks. To determine risk factors for endemic blastomycosis, a case-control study was conducted among southeastern Missouri residents. Independent risk factors for blastomycosis were black race and a prior history of pneumonia. No environmental exposures or socioeconomic factors were significantly associated with increased risk. The increased risk among blacks may possibly be related to genetic factors, but further studies are needed to clarify this. However, heightened awareness of the disease and a better understanding of the risk factors are important and may lead to earlier diagnosis and start of treatment, possibly improving outcome.

Type
Research Article
Information
Epidemiology & Infection , Volume 131 , Issue 2 , October 2003 , pp. 907 - 914
Copyright
2003 Cambridge University Press

Footnotes

Presented in part: 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, September 2000 (abstract ICAAC00-A-023659-ASM).