Blastomycosis epidemiology and demographics: Difference between revisions

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==Overview==
==Overview==
 
The annual [[incidence]] rates of blastomycosis is estimated approximately to be 1 to 2 cases per 100,000 population. Between 1993 and 2003, a total of 500 cases are reported, with the majority of cases coming from the northeastern part of United states. Most of the cases are reported in Wisconsin, Manitoba (Canada), and Ontario. The [[case fatality rate]] of blastomycosis is 0.21 per 1 million individuals when left untreated. Blastomycosis is also seen internationally, as cases are reported from Africa, India, Middle east, Mexico, Central and South America. Men and women are affected equally by blastomycosis. The [[prevalence]] of blastomycosis is not affected by age.  All the individuals who are exposed to the fungi can develop the disease


==Epidemiology==
==Epidemiology==
===Incidence===
===Incidence===
*In states where blastomycosis is reportable, yearly incidence rates are approximately 1 to 2 cases per 100,000 population.
*The [[Incidence (epidemiology)|annual incidence rates]] of blastomycosis is estimated approximately to be 1 to 2 cases per 100,000 population.
*Wisconsin may have the highest incidence of blastomycosis of any state, with yearly rates ranging from 10 to 40 cases per 100,000 persons.<ref name="pmid1420675">{{cite journal |vauthors=Baumgardner DJ, Buggy BP, Mattson BJ, Burdick JS, Ludwig D |title=Epidemiology of blastomycosis in a region of high endemicity in north central Wisconsin |journal=Clin. Infect. Dis. |volume=15 |issue=4 |pages=629–35 |year=1992 |pmid=1420675 |doi= |url=}}</ref>
*Wisconsin has the highest incidence of blastomycosis of any state, with yearly rates ranging from 10 to 40 cases per 100,000 persons.<ref name="pmid1420675">{{cite journal |vauthors=Baumgardner DJ, Buggy BP, Mattson BJ, Burdick JS, Ludwig D |title=Epidemiology of blastomycosis in a region of high endemicity in north central Wisconsin |journal=Clin. Infect. Dis. |volume=15 |issue=4 |pages=629–35 |year=1992 |pmid=1420675 |doi= |url=}}</ref>


===Prevalence===
===Case fatality rate===
===Case fatality rate===
*During 1990-2010, the case fatality rate of blastomycosis is 0.21 per 1 million person.
*During 1990-2010, the [[case fatality rate]] of blastomycosis is 0.21 per 1 million person.<ref name="pmid25339251">{{cite journal |vauthors=Khuu D, Shafir S, Bristow B, Sorvillo F |title=Blastomycosis mortality rates, United States, 1990-2010 |journal=Emerging Infect. Dis. |volume=20 |issue=11 |pages=1789–94 |year=2014 |pmid=25339251 |pmc=4214285 |doi=10.3201/eid2011.131175 |url=}}</ref>


==Demographics==
==Demographics==
===Age===
===Age===
The [[prevalence]] of blastomycosis is not effected by age. All the individuals who are exposed to the [[fungi]] can develop the [[disease]].
===Gender===
===Gender===
Men and women are affected equally by blastomycosis.
*Men and women are affected equally by blastomycosis.


===Race===
===Race===
*There is no racial predilection to blastomycosis
===Geographical Distribution===
===Geographical Distribution===
*In the United States, blastomycosis is endemic in the Mississippi river and Ohio river basins and around the Great Lakes.
*In the United States, blastomycosis is [[Endemic (epidemiology)|endemic]] in southern and southeastern states that border the Ohio River and Mississippi River valleys, as well as in Midwestern states and Canadian provinces that border the Great Lakes and the Saint Lawrence Riverway.
*It is endemic in southern and southeastern states that border the Ohio River and Mississippi River valleys of the United States, as well as in Midwestern states and Canadian provinces that border the Great Lakes and the Saint Lawrence Riverway.
*Blastomycosis is reportable in Arkansas, Louisiana, Michigan, Minnesota, Illinois and Wisconsin.<ref name="pmid8676851">{{cite journal |vauthors= |title=Blastomycosis--Wisconsin, 1986-1995 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=45 |issue=28 |pages=601–3 |year=1996 |pmid=8676851 |doi= |url=}}</ref>
*Historically, most reported cases occurred in Arkansas, Kentucky, Mississippi, North Carolina, Tennessee, Louisiana, Illinois, and Wisconsin (19).
*The disease is [[Endemic (epidemiology)|hyperendemic]]  in north-central Wisconsin and the northern region of Ontario, Canada. <ref name="pmid8676851">{{cite journal |vauthors= |title=Blastomycosis--Wisconsin, 1986-1995 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=45 |issue=28 |pages=601–3 |year=1996 |pmid=8676851 |doi= |url=}}</ref>
*Areas in which the disease is hyperendemic exist in north-central Wisconsin and the northern region of Ontario, Canada (9, 85).
*Blastomycosis is distributed internationally, cases are reported from Africa, India, Middle east, Mexico, Central and South America.<ref name = Alvarez_2006>{{cite journal |author=Alvarez G, Burns B, Desjardins M, Salahudeen S, AlRashidi F, Cameron D |title=Blastomycosis in a young African man presenting with a pleural effusion |journal=Can Respir J |volume=13 |issue=8 |pages=441-4 |year=2006 |pmid=17149463}}</ref>
 
[[File:_Blastomycosis36.jpeg|center|500x500px]]
===Developed Countries===
The annual incidence is less than 1 case per 100,000 people in Mississippi, Louisiana, Kentucky, and Arkansas. The cases are greater in northern states such as Wisconsin, where from 1986 to 1995 there were 1.4 cases per 100,000 people.<ref>{{cite journal |author= |title=Blastomycosis--Wisconsin, 1986-1995 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=45 |issue=28 |pages=601-3 |year=1996 |pmid=8676851 |doi=}}</ref> . Outbreaks or epidemics are known to occur, in a period between 2005-2008 an outbreak was reported in Indianapolis, where 34 cases were diagnosed and coincided with the construction of highways in that area. <ref name="Carlos-2010">{{Cite journal | last1 = Carlos | first1 = WG. | last2 = Rose | first2 = AS. | last3 = Wheat | first3 = LJ. | last4 = Norris | first4 = S. | last5 = Sarosi | first5 = GA. | last6 = Knox | first6 = KS. | last7 = Hage | first7 = CA. | title = Blastomycosis in indiana: digging up more cases. | journal = Chest | volume = 138 | issue = 6 | pages = 1377-82 | month = Dec | year = 2010 | doi = 10.1378/chest.10-0627 | PMID = 20558552 }}</ref> Another outbreak of 55 cases was reported in 2009-2010 in Wisconsin and a large proportion of cases(45%) was seen in the Hmong community, though the exact reason behind their predisposition was not known. This was the largest reported outbreak ever and showed clustering of cases in the neighborhood, which to an extent explains multifactorial environmental sources behind these outbreaks.<ref name="Roy-2013">{{Cite journal | last1 = Roy | first1 = M. | last2 = Benedict | first2 = K. | last3 = Deak | first3 = E. | last4 = Kirby | first4 = MA. | last5 = McNiel | first5 = JT. | last6 = Sickler | first6 = CJ. | last7 = Eckardt | first7 = E. | last8 = Marx | first8 = RK. | last9 = Heffernan | first9 = RT. | title = A large community outbreak of blastomycosis in wisconsin with geographic and ethnic clustering. | journal = Clin Infect Dis | volume = 57 | issue = 5 | pages = 655-62 | month = Sep | year = 2013 | doi = 10.1093/cid/cit366 | PMID = 23735332 }}</ref>


In Canada, most cases of blastomycosis occur in northwestern Ontario, particularly around the Kenora, Ontario area. The moist, acidic soil in the surrounding woodland harbors the fungus. Recently, Quebac was identified as an area endemic for blastomycosis with an incidence of 0.133/100,000. <ref name="Litvinov-2013">{{Cite journal  | last1 = Litvinov | first1 = IV. | last2 = St-Germain | first2 = G. | last3 = Pelletier | first3 = R. | last4 = Paradis | first4 = M. | last5 = Sheppard | first5 = DC. | title = Endemic human blastomycosis in Quebec, Canada, 1988-2011. | journal = Epidemiol Infect | volume = 141 | issue = 6 | pages = 1143-7 | month = Jun | year = 2013 | doi = 10.1017/S0950268812001860 | PMID = 22929032 }}</ref>
Map of eastern United States and Canada showing distribution of blastomycosis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>


===International===
Blastomycosis is distributed internationally; cases are sometimes reported from Africa.<ref name = Alvarez_2006>{{cite journal |author=Alvarez G, Burns B, Desjardins M, Salahudeen S, AlRashidi F, Cameron D |title=Blastomycosis in a young African man presenting with a pleural effusion |journal=Can Respir J |volume=13 |issue=8 |pages=441-4 |year=2006 |pmid=17149463}}</ref> Cases have also been reported from India, Middle east, Mexco, Central and South America.
It was originally thought that the fungus affects middle-aged men who work outdoors, however the studies conducted on reported outbreaks do not show any predilection based on age, sex, race, occupation or season. It prefers to grow in warm, moist soil rich, in organic materials and exposure to soil seems to be the only common factor among patients.
==Gallery==
<gallery>
Image: Blastomycosis36.jpeg|Map of eastern United States and Canada showing distribution of reported cases of blastomycosis. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
</gallery>




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Latest revision as of 20:37, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Vidit Bhargava, M.B.B.S [2] Aditya Ganti M.B.B.S. [3]

Overview

The annual incidence rates of blastomycosis is estimated approximately to be 1 to 2 cases per 100,000 population. Between 1993 and 2003, a total of 500 cases are reported, with the majority of cases coming from the northeastern part of United states. Most of the cases are reported in Wisconsin, Manitoba (Canada), and Ontario. The case fatality rate of blastomycosis is 0.21 per 1 million individuals when left untreated. Blastomycosis is also seen internationally, as cases are reported from Africa, India, Middle east, Mexico, Central and South America. Men and women are affected equally by blastomycosis. The prevalence of blastomycosis is not affected by age. All the individuals who are exposed to the fungi can develop the disease

Epidemiology

Incidence

  • The annual incidence rates of blastomycosis is estimated approximately to be 1 to 2 cases per 100,000 population.
  • Wisconsin has the highest incidence of blastomycosis of any state, with yearly rates ranging from 10 to 40 cases per 100,000 persons.[1]

Case fatality rate

Demographics

Age

The prevalence of blastomycosis is not effected by age. All the individuals who are exposed to the fungi can develop the disease.

Gender

  • Men and women are affected equally by blastomycosis.

Race

  • There is no racial predilection to blastomycosis

Geographical Distribution

  • In the United States, blastomycosis is endemic in southern and southeastern states that border the Ohio River and Mississippi River valleys, as well as in Midwestern states and Canadian provinces that border the Great Lakes and the Saint Lawrence Riverway.
  • Blastomycosis is reportable in Arkansas, Louisiana, Michigan, Minnesota, Illinois and Wisconsin.[3]
  • The disease is hyperendemic in north-central Wisconsin and the northern region of Ontario, Canada. [3]
  • Blastomycosis is distributed internationally, cases are reported from Africa, India, Middle east, Mexico, Central and South America.[4]

Map of eastern United States and Canada showing distribution of blastomycosis. From Public Health Image Library (PHIL). [5]


References

  1. Baumgardner DJ, Buggy BP, Mattson BJ, Burdick JS, Ludwig D (1992). "Epidemiology of blastomycosis in a region of high endemicity in north central Wisconsin". Clin. Infect. Dis. 15 (4): 629–35. PMID 1420675.
  2. Khuu D, Shafir S, Bristow B, Sorvillo F (2014). "Blastomycosis mortality rates, United States, 1990-2010". Emerging Infect. Dis. 20 (11): 1789–94. doi:10.3201/eid2011.131175. PMC 4214285. PMID 25339251.
  3. 3.0 3.1 "Blastomycosis--Wisconsin, 1986-1995". MMWR Morb. Mortal. Wkly. Rep. 45 (28): 601–3. 1996. PMID 8676851.
  4. Alvarez G, Burns B, Desjardins M, Salahudeen S, AlRashidi F, Cameron D (2006). "Blastomycosis in a young African man presenting with a pleural effusion". Can Respir J. 13 (8): 441–4. PMID 17149463.
  5. "Public Health Image Library (PHIL)".

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