An Epidemic of Histoplasmosis on the Isthmus of Panama

W. F. Larrabee Department of Otolaryngology, Tulane University School of Medicine, Mycology Division, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, New Orleans, Louisiana 70112

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L. Ajello Department of Otolaryngology, Tulane University School of Medicine, Mycology Division, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, New Orleans, Louisiana 70112

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L. Kaufman Department of Otolaryngology, Tulane University School of Medicine, Mycology Division, Center for Disease Control, Public Health Service, U.S. Department of Health, Education, and Welfare, New Orleans, Louisiana 70112

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Forty-seven men on the Isthmus of Panama were exposed to histoplasmosis in an old bunker inhabited by bats. The resulting epidemic was studied with serial clinical, serological, and radiological examinations. Thirty-seven (78.7%) of the men showed serological evidence of infection and 26 (70.3%) had symptoms. Incubation periods ranged from 4 to 30 days. A general relationship between severity of illness and degree of exposure was noted. The agar gel diffusion test for precipitin antibodies was more sensitive than the complement-fixation test or slide test in detecting infection with Histoplasma capsulatum. Decontamination procedures and environmental studies are described.

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