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Am. J. Trop. Med. Hyg., 60(6), 1999, pp. 899-903
Copyright © 1999 by The American Society of Tropical Medicine and Hygiene

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American Journal of Tropical Medicine and Hygiene, Vol 60, Issue 6, 899-903
Copyright © 1999 by American Society of Tropical Medicine and Hygiene

Research Articles


Outbreak of histoplasmosis among cavers attending the National Speleological Society Annual Convention, Texas, 1994

DA Ashford, RA Hajjeh, MF Kelley, L Kaufman, L Hutwagner, and MM McNeil

In June 1994, 18 people developed serologically confirmed histoplasmosis following cave exploration associated with the annual National Speleological Society Convention in Bracketville, Texas. Six others had an undiagnosed illness suspected to be histoplasmosis. Two persons were hospitalized. We conducted a survey of convention attendees and a nested case-control study of those entering caves. We also conducted a histoplasmin skin test survey of a subgroup of the society, the Texas Cavers Association, who were attending a reunion in October 1994. Among the national convention attendees, exposure to two caves was identified as responsible for 22 (92%) of the 24 cases; 12 (75%) of 16 people exploring one cave (Cave A) and 10 (77%) of 13 exploring a separate cave (Cave B) developed acute histoplasmosis. Additional risk-factors included fewer years of caving experience, longer time spent in the caves, and entering a confined crawl space in Cave A. Of 113 participants in the separate skin test survey, 68 (60%) were found to be skin test positive, indicating previous exposure to Histoplasma capsulatum. A positive skin test was significantly associated with male sex and more years of caving experience. Those less experienced in caving associations should be taught about histoplasmosis, and health care providers should pursue histories of cave exposure for patients with bronchitis or pneumonia that does not respond to initial antibiotic therapy.


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 Am J Trop Med HygHome page
G. M. LYON, A. V. BRAVO, A. ESPINO, M. D. LINDSLEY, R. E. GUTIERREZ, I. RODRIGUEZ, A. CORELLA, F. CARRILLO, M. M. MCNEIL, D. W. WARNOCK, et al.
HISTOPLASMOSIS ASSOCIATED WITH EXPLORING A BAT-INHABITED CAVE IN COSTA RICA, 1998-1999
Am J Trop Med Hyg, April 1, 2004; 70(4): 438 - 442.
[Abstract] [Full Text] [PDF]

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 JWatch Infect. DiseasesHome page
Caves Are a Source of Histoplasmosis
Journal Watch Infectious Diseases, August 1, 1999; 1999(801): 1 - 1.
[Full Text]


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