Materiały źródłowe

• #1 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  Histoplasmosis is a worldwide distributed non-contagious fungal infection caused by H. capsulatum. […] The existence of H. capsulatum has been reported on all continents, including recently in Antarctica. […] The wide geographic spread of the fungus may be the result of behavioral changes in its natural reservoirs and dispersers as well as climatic changes in its natural habitat. […] The natural habitat for H. capsulatum is soil enriched with bat guano or bird droppings, which favors the growth of its mycelial phase. […] The infection is not contagious, airborne transmission by nasal secretions or direct host-to-host transmission of the fungus have never been established. […] Histoplasmosis occurs, with low or greater endemicity, in some known areas, more frequently in some populations (e.g., up to 25% of people living with HIV in hyper-endemic areas develop manifest histoplasmosis).

• #1 Evolving Epidemiology, Improving Diagnostic Tests and Their Importance for the Correct Diagnosis of Histoplasmosis

  https://www.mdpi.com/2309-608X/11/3/196

  Histoplasmosis has traditionally been described as having discrete geographic areas of endemicity. […] Our understanding of where histoplasmosis occurs has improved in recent years due to improving access to diagnostic testing and increased reporting as well as larger at-risk populations (HIV and non-HIV immune suppression) resulting in more cases. […] At present, the data are telling us that histoplasmosis is occurring in most parts of the world but is particularly common in much of North America, South and Central America, as well as large parts of Africa and to a lesser degree (so far) Europe, Asia, Australia, and even Antarctica. […] In Latin America, the lack of surveillance of fungal infections in many countries has contributed to lack of the recognition of the true prevalence of this mycosis.

• #2 Histoplasmosis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/histoplasmosis.html

  The fungus is found throughout the world and grows in soil that has been enriched with bat or bird droppings or in bat droppings themselves. […] The disease is not spread from person to person. It is not acquired from animals that have the disease. […] The following steps can be taken to reduce exposure to Histoplasma capsulatum: prevent bats and birds from entering buildings to prevent the buildup of droppings, avoid areas that may harbor the fungus, particularly those areas with accumulations of bird or bat droppings. […] Large accumulations of bird or bat droppings should be removed by a professional cleanup and restoration firm experienced with hazardous waste disposal.

• #2 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  Histoplasmosis is a worldwide distributed non-contagious fungal infection caused by H. capsulatum. […] The existence of H. capsulatum has been reported on all continents, including recently in Antarctica. […] The wide geographic spread of the fungus may be the result of behavioral changes in its natural reservoirs and dispersers as well as climatic changes in its natural habitat. […] The natural habitat for H. capsulatum is soil enriched with bat guano or bird droppings, which favors the growth of its mycelial phase. […] The infection is not contagious, airborne transmission by nasal secretions or direct host-to-host transmission of the fungus have never been established. […] Histoplasmosis occurs, with low or greater endemicity, in some known areas, more frequently in some populations (e.g., up to 25% of people living with HIV in hyper-endemic areas develop manifest histoplasmosis).

• #3 Histoplasmosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448185/

  Histoplasmosis is the most common endemic mycosis in the United States. It is not a reportable disease. The presumed geographic distribution and endemicity are the Midwest and Southeastern regions of the United States. This information is largely derived from skin test surveys performed during the 1940s. Between 1938 through 2013 over 100 outbreaks involving approximately 3000 cases have been reported in 26 states and the territory of Puerto Rico. In the above publication, an outbreak was defined as two or more cases. Common exposure settings were chicken coops or construction projects. Birds, bats, or their droppings were reported to be present in 77% of the outbreak settings, and workplace exposures were reported in half of the outbreaks. In endemic regions and sporadic cases, the exact exposure is difficult to pinpoint, as frequently symptoms are due to reactivation of the disease.

• #4 Histoplasmosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/299054-overview

  Histoplasmosis is the most common endemic fungal infection seen in humans. The central river valleys in the midwestern and south central United States are endemic for histoplasmosis. Approximately 250,000 individuals are infected annually. Clinical manifestations of histoplasmosis occur in less than 5% of the population. Most infections are sporadic, although large outbreaks of histoplasmosis may occur. […] Population studies have demonstrated that greater than 80% of young adults from endemic areas (Ohio Valley, Mississippi Valley) have been previously infected with H capsulatum. […] Patients in endemic areas receiving TNF- inhibitors (infliximab, etanercept, adalimumab, certolizumab, golimumab) are at increased risk for histoplasmosis. The incidence of histoplasmosis with infliximab has been estimated to be 18.75 per 100,000 persons, while the incidence with etanercept has been estimated at 2.65 per 100,000 persons.

• #5 Epidemiology, clinical manifestations, and diagnosis of histoplasmosis in patients with HIV – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-histoplasmosis-in-patients-with-hiv

  Epidemiology, clinical manifestations, and diagnosis of histoplasmosis in patients with HIV […] Histoplasmosis is the most common endemic mycosis in patients with acquired immunodeficiency syndrome (AIDS). Although the risk of disease in patients with human immunodeficiency virus (HIV) has declined with effective antiretroviral therapy, it continues to cause severe morbidity and mortality in endemic areas, particularly in resource-limited settings. […] The epidemiology, clinical manifestations, and diagnosis of histoplasmosis in patients with HIV will be reviewed here. […] Geographic distribution – Histoplasmosis is found in temperate zones worldwide, including areas of Australia, Southeast Asia, and Africa; specific endemic areas include the Mississippi and Ohio river valleys, the Caribbean, southern Mexico, and certain parts of Central and South America. In these regions, the fungus is found in high concentrations in soil contaminated with bird or bat excreta.

• #6 Histoplasmosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448185/

  Worldwide there are pockets of endemicity on each continent. Published cases have been reported from Italy in Europe, from North, Central and South America, West Africa (Congo and Zimbabwe), South Africa, Southeast Asia (India, China, Malaysia, Taiwan), and Australia. More than half the worlds population potentially lives in the endemic region of H. capsulatum.

• #7 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The distribution of these cases extends beyond the originally defined boundaries of the US river valleys, encompassing states in the north (Minnesota, Wisconsin, Michigan), northeast (New York), and west (California, Arizona, Idaho, and Montana). […] In Canada, histoplasmosis is considered endemic in the regions adjacent to the St. Lawrence River and the Great Lakes, especially Quebec and Ontario. […] Histoplasmosis is endemic in Central and South America, excepting the western part of the two continents (west Mexico and Peru, and most of Chile). […] Histoplasmosis is an increasing challenge for the Latin American population, especially the disseminated form of the disease occurring in HIV-positive patients. […] In a large prospective cohort study, conducted in Guatemala between 2005 and 2009, which enrolled HIV-positive patients with suspected histoplasmosis, crude mortality in patients with histoplasmosis was 43.6 versus 30.8% among no-histoplasmosis patients.

• #8 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The distribution of these cases extends beyond the originally defined boundaries of the US river valleys, encompassing states in the north (Minnesota, Wisconsin, Michigan), northeast (New York), and west (California, Arizona, Idaho, and Montana). […] In Canada, histoplasmosis is considered endemic in the regions adjacent to the St. Lawrence River and the Great Lakes, especially Quebec and Ontario. […] Histoplasmosis is endemic in Central and South America, excepting the western part of the two continents (west Mexico and Peru, and most of Chile). […] Histoplasmosis is an increasing challenge for the Latin American population, especially the disseminated form of the disease occurring in HIV-positive patients. […] In a large prospective cohort study, conducted in Guatemala between 2005 and 2009, which enrolled HIV-positive patients with suspected histoplasmosis, crude mortality in patients with histoplasmosis was 43.6 versus 30.8% among no-histoplasmosis patients.

• #9 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  A robust study of more than 58% of the newly diagnosed HIV patients, reported by the national HIV program during 2017-2018, in Guatemala found that histoplasmosis was the most common opportunistic infection, with an overall incidence of 7.9%. […] The prognosis of disseminated histoplasmosis in Africa is poor, fatality rates varying between 23% for H. capsulatum var. duboisii and 50% for H. capsulatum var. capsulatum infections. […] In Europe, the disease is rarely reported and is considered a predominantly imported disease. […] The majority of cases are linked to travel in endemic areas or immigration. […] In conclusion, doctors from non-endemic areas must consider in certain cases the differential diagnosis with histoplasmosis in immunosuppressed patients and especially in those with HIV infection, because early diagnosis and rapid institution of therapy improve the outcome of the disease and patients survival.

• #10 Epidemiological Survey on Histoplasmosis – ECMM

  https://www.ecmm.info/working-groups/epidemiological-survey-histoplasmosis/

  The ECMM survey on histoplasmosis in Europe was set up in March 1997 to examine the epidemiology of this disease in Europe. It aimed to assess how frequently histoplasmosis occurred in Europe, where and how the infection was acquired, groups at risk, the causative organism, the methods by which the infection was diagnosed and what therapy patients received. […] Overall, 127 cases were reported, with 70 occurring in the retrospective phase of the survey and 57 during the prospective phase. […] The number of cases reported from each country varied significantly and this is thought to be due to the ways in which the disease was diagnosed. […] Because primary pulmonary histoplasmosis is often self-limiting, most cases will go undiagnosed and so the cases reported in the survey are likely to represent the tip of the iceberg.

• #11 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  Histoplasmosis is a worldwide distributed non-contagious fungal infection caused by H. capsulatum. […] The existence of H. capsulatum has been reported on all continents, including recently in Antarctica. […] The wide geographic spread of the fungus may be the result of behavioral changes in its natural reservoirs and dispersers as well as climatic changes in its natural habitat. […] The natural habitat for H. capsulatum is soil enriched with bat guano or bird droppings, which favors the growth of its mycelial phase. […] The infection is not contagious, airborne transmission by nasal secretions or direct host-to-host transmission of the fungus have never been established. […] Histoplasmosis occurs, with low or greater endemicity, in some known areas, more frequently in some populations (e.g., up to 25% of people living with HIV in hyper-endemic areas develop manifest histoplasmosis).

• #12 Histoplasmosis: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/histoplasmosis

  Histoplasmosis is acquired by the inhalation of microconidia that form in the mycelial phase of the fungus in the environment. Asymptomatic dissemination of infection beyond the lungs is common, and cellular immunity is critical in controlling infection. Diminished cellular immunity can lead to a reactivation of a quiescent focal infection acquired years earlier; this is the presumed mechanism for disease occurrence in nonendemic areas. […] The detection of Histoplasma antigen in blood or urine (the detection method preferred by the World Health Organization) is a sensitive method for the rapid diagnosis of disseminated histoplasmosis in people with HIV. This test should be obtained for any person with HIV and low CD4 counts who has the above-mentioned symptoms and who lives, or has previously lived, in an area in which H. capsulatum is commonly found.

• #13 Occupational Histoplasmosis: Epidemiology and Prevention Measures

  https://www.mdpi.com/2309-608X/7/7/510

  Based on public health surveillance, environmental data, and outbreak investigations, the geographic distribution of histoplasmosis is likely wider than currently recognized. […] In general, environmental disruption of Histoplasma habitats is a key factor associated with histoplasmosis outbreaks. […] A previous review found that approximately one-third of documented histoplasmosis outbreaks were work-related. […] Examples of workers affected in previous histoplasmosis outbreaks include bridge workers, construction or demolition workers, farmers, landscapers or tree removal workers, and microbiology laboratory workers. […] These specific activities also appear to be potential exposure sources for non-outbreak-associated (i.e., sporadic) histoplasmosis cases, though to a lesser extent.

• #14 Histoplasmosis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/histoplasmosis.html

  Anyone can get histoplasmosis. In some areas where the fungus is common, 80 percent or more of the population has been exposed to the fungus by breathing in airborne spores. […] Elevated risk of exposure to the histoplasmosis fungus include: workers who perform demolition or renovation work in buildings where bat or bird droppings have accumulated, gardeners who use bird or bat droppings as fertilizer, excavation workers who uproot trees that have been used for bird or bat roosting, persons cleaning fireplaces below chimneys in which bats or birds have roosted. […] Long-term smokers and those with preexisting lung disease may be at higher risk for developing the disease. People with severely compromised immune systems such as those with AIDS or leukemia, persons on steroid therapy, those on chemotherapy, and recent transplant recipients are vulnerable to a very serious disease known as progressive disseminated histoplasmosis.

• #15 Epidemiology, clinical manifestations, and diagnosis of histoplasmosis in patients with HIV – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-histoplasmosis-in-patients-with-hiv

  Sources of infection – Transmission occurs via inhalation of Histoplasma capsulatum conidia from the soil. Thus, infection may be acquired through a multitude of activities (eg, demolition and construction, cleaning out old structures or chicken coops, spelunking, and gardening or handling of plants), which can lead to inhalation of the pathogen through contaminated soil. Most primary cases of infection occur shortly after initial exposure; disseminated infection has also been described in patients living outside of endemic areas, suggesting endogenous reactivation of latent foci of infection that were acquired from previous travel or residence in endemic areas. […] Burden of disease – Early in the HIV epidemic, histoplasmosis occurred in 5 to 27 percent of patients with advanced HIV living in endemic areas of the United States. Despite the risk of disease declining with effective antiretroviral therapy, histoplasmosis remains one of the most common infections among persons with HIV living in Latin America.

• #16 Occupational Histoplasmosis: Epidemiology and Prevention Measures

  https://www.mdpi.com/2309-608X/7/7/510

  Based on public health surveillance, environmental data, and outbreak investigations, the geographic distribution of histoplasmosis is likely wider than currently recognized. […] In general, environmental disruption of Histoplasma habitats is a key factor associated with histoplasmosis outbreaks. […] A previous review found that approximately one-third of documented histoplasmosis outbreaks were work-related. […] Examples of workers affected in previous histoplasmosis outbreaks include bridge workers, construction or demolition workers, farmers, landscapers or tree removal workers, and microbiology laboratory workers. […] These specific activities also appear to be potential exposure sources for non-outbreak-associated (i.e., sporadic) histoplasmosis cases, though to a lesser extent.

• #17 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The real burden of the disease seems to be underestimated because it is frequently misdiagnosed as tuberculosis, community-acquired pneumonia or other acute lower respiratory tract infections, and underdiagnosed due to poor availability of diagnostic tests. […] Recent global estimates found almost 500,000 cases of histoplasmosis and approximately 100,000 cases of disseminated histoplasmosis occurring annually. […] The geographic distribution of H. capsulatum in North America remains still unclear and requires further investigations. […] In highly endemic areas around the US river valleys, population skin delayed type hypersensitivity to histoplasmin is around 90%, meaning that residents of these areas were exposed to the primary infection at some point in their lifetime. […] Epidemiological reports and studies have shown many cases of histoplasmosis diagnosed in humans or animals outside historically recognized endemic areas.

• #18 Evolving Epidemiology, Improving Diagnostic Tests and Their Importance for the Correct Diagnosis of Histoplasmosis

  https://www.mdpi.com/2309-608X/11/3/196

  In 2017, the total estimated annual incidence of histoplasmosis was ~100,000 cases worldwide. […] The mortality rate was 40% in PLWHA with LT-CD4+ < 200 cells/μL, resulting in 9600 deaths per year from histoplasmosis, more than from tuberculosis (~6000 deaths) in Latin America. [...] The United States is a highly endemic country for histoplasmosis, with very high rates in the Mississippi and Ohio Valley regions but also with cases being reported throughout much of the country. [...] Between 2001 and 2006, 15 centers of the Transplant-Associated Infection Surveillance Network registered 52 cases of histoplasmosis, of which 48 occurred in solid organ transplant recipients and 4 in hematopoietic cell recipients. [...] Africa has seen a steady rise in the number of histoplasmosis cases reported following an increase in medical mycology advocacy and clinician sensitization to the presence of a number of fungal infections.

• #19 Facts and Stats About Histoplasmosis | Histoplasmosis | CDC

  https://www.cdc.gov/histoplasmosis/php/statistics/index.html

  Histoplasmosis is not a nationally reportable disease. […] The average annual incidence is between 1 to 2 cases per 100,000 population. […] Among states where histoplasmosis is reportable, average annual incidence is between 1 to 2 cases per 100,000 population. However, state-specific annual incidence ranges from 0 to 7 cases per 100,000 population according to recent surveillance data. […] Death rates are generally around 5%, though higher rates among adults have been reported. […] Among people who are hospitalized with histoplasmosis, death rates generally range from 5% to 7%. […] The overall mortality rate for histoplasmosis is likely lower than these estimates because these studies did not include patients who had less severe forms of the infection.

• #20 Overview of Histoplasmosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/1215/p2247.html

  Histoplasmosis is an endemic infection in most of the United States and can be found worldwide. […] An estimated 40 million people in the United States have been infected with H. capsulatum, with 500,000 new cases occurring each year. […] The mycelial form of H. capsulatum is found in the soil, especially in areas contaminated with bird or bat droppings, which provide added nutrients for growth. Infections in endemic areas are typically caused by wind-borne spores emanating from point sources such as bird roosts, old houses or barns, or activities involving disruption of the soil such as farming and excavation. H. capsulatum infection is not transmissible through person-to-person contact.

• #21 Histoplasmosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/299054-overview

  Histoplasmosis is the most common endemic fungal infection seen in humans. The central river valleys in the midwestern and south central United States are endemic for histoplasmosis. Approximately 250,000 individuals are infected annually. Clinical manifestations of histoplasmosis occur in less than 5% of the population. Most infections are sporadic, although large outbreaks of histoplasmosis may occur. […] Population studies have demonstrated that greater than 80% of young adults from endemic areas (Ohio Valley, Mississippi Valley) have been previously infected with H capsulatum. […] Patients in endemic areas receiving TNF- inhibitors (infliximab, etanercept, adalimumab, certolizumab, golimumab) are at increased risk for histoplasmosis. The incidence of histoplasmosis with infliximab has been estimated to be 18.75 per 100,000 persons, while the incidence with etanercept has been estimated at 2.65 per 100,000 persons.

• #22 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The real burden of the disease seems to be underestimated because it is frequently misdiagnosed as tuberculosis, community-acquired pneumonia or other acute lower respiratory tract infections, and underdiagnosed due to poor availability of diagnostic tests. […] Recent global estimates found almost 500,000 cases of histoplasmosis and approximately 100,000 cases of disseminated histoplasmosis occurring annually. […] The geographic distribution of H. capsulatum in North America remains still unclear and requires further investigations. […] In highly endemic areas around the US river valleys, population skin delayed type hypersensitivity to histoplasmin is around 90%, meaning that residents of these areas were exposed to the primary infection at some point in their lifetime. […] Epidemiological reports and studies have shown many cases of histoplasmosis diagnosed in humans or animals outside historically recognized endemic areas.

• #23 Histoplasmosis Statistics and Maps – MN Dept. of Health

  https://www.health.state.mn.us/diseases/histoplasmosis/stats.html

  Histoplasmosis is a rare fungal infection caused by Histoplasma capsulatum, which is found in the environment. […] A median of 189 cases of histoplasmosis are reported each year. Around 50 cases/year are classified epidemiologically as confirmed. […] Histoplasmosis occurs most frequently in middle-age and older adults. The median age of cases is 50 years, and cases range from 0 92 years of age. Male cases make up 61% of cases. […] This map shows the average number of cases of histoplasmosis per 100,000 people that occur each year in Minnesotas counties. The highest numbers are in the southern and western parts of the state. […] Slightly fewer cases are diagnosed in late winter and early spring, but there is not a clear season for histoplasmosis infections.

• #24 Histoplasmosis | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/histoplasmosis.htm

  Approximately 30 cases are reported each year in Wisconsin. […] This is a Wisconsin disease surveillance category II disease: […] Report to the patient’s local public health department electronically, through the Wisconsin Electronic Disease Surveillance System (WEDSS), by mail or fax using an Acute and Communicable Disease case report, F-44151 (Word) or by other means within 72 hours upon recognition of a case. […] Information on communicable disease reporting. […] Case Reporting and Investigation Protocol (EpiNet): P-01914, Histoplasmosis (PDF) August 2017.

• #25 Histoplasmosis

  https://www.michigan.gov/mdhhs/safety-injury-prev/environmental-health/topics/mitracking/histoplasmosis

  Between 2016-2020, an average of 186 human cases of histoplasmosis were reported each year to the Michigan Department of Health and Human Services (MDHHS). […] Histoplasmosis is reportable in certain states, including Michigan. Physicians and laboratories are required to report suspected cases of histoplasmosis to the Michigan Disease Surveillance System or the local health department. […] The number of human cases of histoplasmosis by year of onset, both statewide and by county of residence. […] The rate of histoplasmosis cases statewide. […] If the number or incidence of human cases of histoplasmosis is going up or down over time.

• #26 HISTOPLASMOSIS

  https://www.in.gov/health/reports/disease/1996_new/histoplasmosis.html

  Cases = 75 […] Crude incidence rate = 1.35/100,000 […] The incidence of histoplasmosis was 1.35/100,000 persons in 1996. […] Since August 1988 when histoplasmosis became reportable in Indiana, surveillance data indicate that the number of cases has decreased gradually. […] Sex-specific incidence rates indicate males have over 3 times higher risk of getting the disease than females. The incidence rate for males was 2.12/100,000 vs. only 0.63/100,000 for females. […] Individuals in the 40-59 year old age group appear to be at higher risk of developing clinical disease.

• #27 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The distribution of these cases extends beyond the originally defined boundaries of the US river valleys, encompassing states in the north (Minnesota, Wisconsin, Michigan), northeast (New York), and west (California, Arizona, Idaho, and Montana). […] In Canada, histoplasmosis is considered endemic in the regions adjacent to the St. Lawrence River and the Great Lakes, especially Quebec and Ontario. […] Histoplasmosis is endemic in Central and South America, excepting the western part of the two continents (west Mexico and Peru, and most of Chile). […] Histoplasmosis is an increasing challenge for the Latin American population, especially the disseminated form of the disease occurring in HIV-positive patients. […] In a large prospective cohort study, conducted in Guatemala between 2005 and 2009, which enrolled HIV-positive patients with suspected histoplasmosis, crude mortality in patients with histoplasmosis was 43.6 versus 30.8% among no-histoplasmosis patients.

• #28 The global epidemiology of emerging Histoplasma species in recent years

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7714791/

  We confirm that histoplasmosis has significantly broadened its area of occurrence, an important feature of emerging pathogens. […] Our findings go beyond the genetic diversity previously reported, which strengthens the importance of more epidemiological investigations in Brazil. […] This is supported by the high incidence of histoplasmosis in Brazil, with 2.19 cases per 1000 hospital admissions, especially among HIV patients. […] Our findings significantly broaden the area of histoplasmosis occurrence, an important feature of emerging pathogens.

• #29 Histoplasmosis in Africa: An emerging or a neglected disease? | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006046

  Histoplasmosis in Africa has markedly increased since the advent of the HIV/AIDS epidemic but is under-recognised. […] The true global burden of histoplasmosis is not well documented despite its endemicity and not addressed previously for Africa. Histoplasmosis is not a notifiable disease, thus hard data on the incidence and prevalence, as well as information on its morbidity and mortality, are fragmentary or not available in many endemic areas. […] Histoplasmosis, including both Hcd and Hcc, has been reported from 32 countries in Africa. […] Our exhaustive literature search revealed a total of 470 documented cases of histoplasmosis reported from the African continent (Table 1) dating from 1952 to 2017. […] The distribution of the disease across Africa (Fig 1) is far from uniform; Hcd was predominantly reported in West, Central, and East Africa.

• #30 Histoplasmosis in the Republic of Congo dominated by African histoplasmosis, Histoplasma capsulatum var. duboisii | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009318

  The Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. […] We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 13 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. […] The knowledge gap of the local epidemiology of this disease is a serious limitation for effective infection control and treatment approaches. Therefore, we performed in this study an exhaustive review of the published cases from 1950 to 2019, including some cases published in non-English language, to provide the current status of histoplasmosis in the RoC regarding the epidemiology, diagnostic tools, and treatment.

• #31 Histoplasmosis – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/histoplasmosis/

  Anyone can get histoplasmosis, even people who are otherwise healthy, if he or she has been in an area where the fungus lives in the environment. Histoplasma capsulatum is found throughout the world and is common in many areas of the United States, including parts of Virginia. […] Certain people are at increased risk for developing severe disease. These include people with weakened immune systems (e.g., people with HIV/AIDS, people who have an organ transplant, people taking medications that weaken the immune system), infants, and people aged 55 years and older. […] The fungus grows in soil that has been enriched with bird or bat droppings. The fungus produces spores that get into the air if the contaminated soil is disturbed. Breathing in these spores causes infection. […] There is no vaccine to prevent histoplasmosis, and it is not always possible to prevent exposure to the fungus in areas where the fungus is common in the environment.

• #32 Histoplasmosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/24811-histoplasmosis

  Its most commonly found in the Midwestern U.S., Africa, and South and Central America. […] Its estimated that about 75% of adults who live in areas where H. capsulatum is common have been infected before, even if they never had symptoms. […] Youre more at risk for histoplasmosis if you have a job or hobbies that can disturb large concentrations of the fungus. […] Youre more at risk for severe or chronic cases of histoplasmosis if you: Have a weakened immune system. HIV and immunosuppressive medications are common causes of a weakened immune system. […] Most people breathe in H. capsulatum without getting sick. But some people, especially those who are exposed to a lot of fungi or who have certain health conditions, can get noticeable symptoms. […] Histoplasmosis can be hard to avoid if you live in an area where the fungus grows. Most cases arent serious and go away on their own. But if you have lung disease or a weakened immune system, youre at higher risk for serious complications of histoplasmosis.

• #33 Histoplasmosis – EMCrit Project

  https://emcrit.org/ibcc/histoplasmosis/

  Risk factors for the development of chronic cavitary pulmonary histoplasmosis include: (34498137) Older age, Chronic structural lung disease (e.g., emphysema, lung cavitation due to sarcoidosis), Underlying immunosuppressive disorders, use of immunosuppressive medications (including steroid), Male sex. […] Immunocompetent patients: Disseminated disease may occur in patients who are immunocompetent. For example, about a third of patients with CNS histoplasmosis have no identified cause of immunodeficiency (typically middle-aged or elderly men). (30921084) However, disseminated disease is more common among patients with deficient cell-mediated immunity. […] HIV patients (especially with CD4 count 100-150/uL). (34498137) Progressive disseminated disease is the most common presentation (95%) among patients with HIV and low CD4 count. (36836350)

• #34 Histoplasmosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/299054-overview

  Histoplasmosis is the most common endemic fungal infection seen in humans. The central river valleys in the midwestern and south central United States are endemic for histoplasmosis. Approximately 250,000 individuals are infected annually. Clinical manifestations of histoplasmosis occur in less than 5% of the population. Most infections are sporadic, although large outbreaks of histoplasmosis may occur. […] Population studies have demonstrated that greater than 80% of young adults from endemic areas (Ohio Valley, Mississippi Valley) have been previously infected with H capsulatum. […] Patients in endemic areas receiving TNF- inhibitors (infliximab, etanercept, adalimumab, certolizumab, golimumab) are at increased risk for histoplasmosis. The incidence of histoplasmosis with infliximab has been estimated to be 18.75 per 100,000 persons, while the incidence with etanercept has been estimated at 2.65 per 100,000 persons.

• #35 Pathogenesis and clinical features of pulmonary histoplasmosis – UpToDate

  https://www.uptodate.com/contents/pathogenesis-and-clinical-features-of-pulmonary-histoplasmosis

  Histoplasmosis is the most prevalent endemic mycosis in the United States, and is the one that most commonly requires hospitalization. […] Epidemiology: H. capsulatum is found worldwide, including areas in Australia, Southeast Asia, and Africa, but is most common in the Midwestern and Central United States, along the Ohio and Mississippi River Valleys and in Latin America. […] Epidemiological studies based on genomic analysis of isolates from patients and modeling studies from public health surveillance data have emphasized that the geographic areas endemic for histoplasmosis in North America appear to be increasing.

• #36

  https://journals.lww.com/epidem/fulltext/2022/09000/integrating_public_health_surveillance_and.8.aspx

  In the United States, the true geographic distribution of the environmental fungus Histoplasma capsulatum remains poorly understood but appears to have changed since it was first characterized. […] Due to limited public health surveillance and under detection of infections, it is challenging to directly use reported case data to characterize spatial risk. […] We estimate areas with higher probabilities of the presence of H. capsulatum in the East North Central states around the Great Lakes, reflecting a shift of the endemic region to the north from previous estimates. […] This work aims to help inform future surveillance needs, clinical awareness, and testing decisions for histoplasmosis. […] Furthermore, public health surveillance data, although subject to underdetection of cases and limited to only a dozen states that require reporting of histoplasmosis, indicate that cases routinely occur in North Central states not previously considered to be endemic.

• #37

  https://journals.lww.com/epidem/fulltext/2022/09000/integrating_public_health_surveillance_and.8.aspx

  Our results provide an increased understanding of the areas with the highest probability of the presence of H. capsulatum. […] We used a Bayesian occupancy model to relate monthly reported cases of histoplasmosis to the latent presence of H. capsulatum, while accounting for differences in case reporting frequency. […] Thus, analyzing the case data without accounting for imperfect detection of histoplasmosis will likely underestimate the true presence and yield biased statistical inference. […] We found that the northern Midwestern United States and the eastern Atlantic coastal region had the highest estimated probability of the presence of H. capsulatum, suggesting that the spatial risk of histoplasmosis has changed from what was originally described in the 1950s. […] This finding is consistent with previous work suggesting an expansion of the endemic areas.

• #38 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  Histoplasmosis is a worldwide distributed non-contagious fungal infection caused by H. capsulatum. […] The existence of H. capsulatum has been reported on all continents, including recently in Antarctica. […] The wide geographic spread of the fungus may be the result of behavioral changes in its natural reservoirs and dispersers as well as climatic changes in its natural habitat. […] The natural habitat for H. capsulatum is soil enriched with bat guano or bird droppings, which favors the growth of its mycelial phase. […] The infection is not contagious, airborne transmission by nasal secretions or direct host-to-host transmission of the fungus have never been established. […] Histoplasmosis occurs, with low or greater endemicity, in some known areas, more frequently in some populations (e.g., up to 25% of people living with HIV in hyper-endemic areas develop manifest histoplasmosis).

• #39 Evolving Epidemiology, Improving Diagnostic Tests and Their Importance for the Correct Diagnosis of Histoplasmosis

  https://www.mdpi.com/2309-608X/11/3/196

  Although histoplasmosis is understood to occur in the Americas and Africa, non-endemic areas, including Europe, Asia, and Oceania, have reported an increasing number of cases due to global travel, migration, immunocompromised populations, and higher suspicion of the disease. […] The reported prevalence of histoplasmosis across the African continent varies according to region. […] In conclusion, histoplasmosis is increasingly recognized in non-endemic regions, including Europe, Asia, and Oceania, driven by globalization and the rise of immunocompromised populations.

• #40 Facts and Stats About Histoplasmosis | Histoplasmosis | CDC

  https://www.cdc.gov/histoplasmosis/php/statistics/index.html

  Histoplasmosis is not a nationally reportable disease. […] The average annual incidence is between 1 to 2 cases per 100,000 population. […] Among states where histoplasmosis is reportable, average annual incidence is between 1 to 2 cases per 100,000 population. However, state-specific annual incidence ranges from 0 to 7 cases per 100,000 population according to recent surveillance data. […] Death rates are generally around 5%, though higher rates among adults have been reported. […] Among people who are hospitalized with histoplasmosis, death rates generally range from 5% to 7%. […] The overall mortality rate for histoplasmosis is likely lower than these estimates because these studies did not include patients who had less severe forms of the infection.

• #41 Histoplasmosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448185/

  Histoplasmosis is the most common endemic mycosis in the United States. It is not a reportable disease. The presumed geographic distribution and endemicity are the Midwest and Southeastern regions of the United States. This information is largely derived from skin test surveys performed during the 1940s. Between 1938 through 2013 over 100 outbreaks involving approximately 3000 cases have been reported in 26 states and the territory of Puerto Rico. In the above publication, an outbreak was defined as two or more cases. Common exposure settings were chicken coops or construction projects. Birds, bats, or their droppings were reported to be present in 77% of the outbreak settings, and workplace exposures were reported in half of the outbreaks. In endemic regions and sporadic cases, the exact exposure is difficult to pinpoint, as frequently symptoms are due to reactivation of the disease.

• #42 Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis — United States, 2019 | MMWR

  https://www.cdc.gov/mmwr/volumes/71/ss/ss7107a1.htm

  In 2019, a total of 20,061 confirmed coccidioidomycosis, 1,124 confirmed and probable histoplasmosis, and 240 confirmed and probable blastomycosis cases were reported to CDC. […] The national incidence of coccidioidomycosis, histoplasmosis, and blastomycosis is poorly characterized. […] Improved surveillance is necessary to better characterize coccidioidomycosis severity and to improve detection of histoplasmosis and blastomycosis. […] Public health response to these three diseases is hindered because information gathered from states routine surveillance does not include data on populations at risk and sources of exposure. […] National surveillance of coccidioidomycosis, histoplasmosis, and blastomycosis can be improved and expanded to include more states and data elements. […] High mortality and hospitalization rates for histoplasmosis and blastomycosis suggest underreporting of mild and severe disease while highlighting their severe clinical outcomes. […] Improved and expanded surveillance would allow a more robust public health response to these diseases.

• #43 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The real burden of the disease seems to be underestimated because it is frequently misdiagnosed as tuberculosis, community-acquired pneumonia or other acute lower respiratory tract infections, and underdiagnosed due to poor availability of diagnostic tests. […] Recent global estimates found almost 500,000 cases of histoplasmosis and approximately 100,000 cases of disseminated histoplasmosis occurring annually. […] The geographic distribution of H. capsulatum in North America remains still unclear and requires further investigations. […] In highly endemic areas around the US river valleys, population skin delayed type hypersensitivity to histoplasmin is around 90%, meaning that residents of these areas were exposed to the primary infection at some point in their lifetime. […] Epidemiological reports and studies have shown many cases of histoplasmosis diagnosed in humans or animals outside historically recognized endemic areas.

• #44

  https://journals.lww.com/epidem/fulltext/2022/09000/integrating_public_health_surveillance_and.8.aspx

  Our current population-level understanding of histoplasmosis is primarily based on passive public health disease surveillance data. […] Despite these advances, surveillance remains limited in geographic scope and in the level of detail of the data collected. […] Additionally, understanding the spatial risk of histoplasmosis is complicated by challenges with detection. […] A prior study developed a suitability score for H. capsulatum based on environmental characteristics but did not account for under detection of reported histoplasmosis cases. […] Ignoring under detection can result in biased statistical inference about the presence of H. capsulatum. […] We developed a spatio-temporal occupancy model to estimate the endemic region for histoplasmosis. […] This represents a novel application of a common ecological model to a problem in environmental and infectious disease epidemiology.

• #45 Epidemiology and Knowledge Gap of Histoplasmosis in Africa | IntechOpen

  https://www.intechopen.com/chapters/87565

  Thus, there is a general knowledge gap among health workers in Africa to diagnose histoplasmosis. […] Pulmonary histoplasmosis could be mostly misdiagnosed as pulmonary tuberculosis since it presents with similar clinical presentations. […] Because histoplasmosis and tuberculosis (TB) present clinically similarly, some misdiagnoses may occur due to a lack of diagnostic resources. […] Despite not being on the World Health Organizations official list, Hcd histoplasmosis is regarded as a neglected tropical illness. […] The general lack of expertise in Africa to skillfully diagnose histoplasmosis makes it difficult to accurately diagnose histoplasmosis. […] There is an urgent need for more precise and user-friendly diagnostic tools to confirm diagnoses and distinguish between Hcd and Hcc disorders, both of which are prevalent on the African continent. […] Most of Africas health national health systems are incapacitated to diagnose histoplasmosis due to a lack of expertise and diagnostic technologies, thus causing miss diagnosis of the same disease.

• #46 Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis — United States, 2019 | MMWR

  https://www.cdc.gov/mmwr/volumes/71/ss/ss7107a1.htm

  In 2019, a total of 20,061 confirmed coccidioidomycosis, 1,124 confirmed and probable histoplasmosis, and 240 confirmed and probable blastomycosis cases were reported to CDC. […] The national incidence of coccidioidomycosis, histoplasmosis, and blastomycosis is poorly characterized. […] Improved surveillance is necessary to better characterize coccidioidomycosis severity and to improve detection of histoplasmosis and blastomycosis. […] Public health response to these three diseases is hindered because information gathered from states routine surveillance does not include data on populations at risk and sources of exposure. […] National surveillance of coccidioidomycosis, histoplasmosis, and blastomycosis can be improved and expanded to include more states and data elements. […] High mortality and hospitalization rates for histoplasmosis and blastomycosis suggest underreporting of mild and severe disease while highlighting their severe clinical outcomes. […] Improved and expanded surveillance would allow a more robust public health response to these diseases.

• #47 Histoplasmosis | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/histoplasmosis.htm

  Approximately 30 cases are reported each year in Wisconsin. […] This is a Wisconsin disease surveillance category II disease: […] Report to the patient’s local public health department electronically, through the Wisconsin Electronic Disease Surveillance System (WEDSS), by mail or fax using an Acute and Communicable Disease case report, F-44151 (Word) or by other means within 72 hours upon recognition of a case. […] Information on communicable disease reporting. […] Case Reporting and Investigation Protocol (EpiNet): P-01914, Histoplasmosis (PDF) August 2017.

• #48 Histoplasmosis (Histoplasma capsulatum) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/histoplasmosis/index.html

  Histoplasmosis occurs primarily in the Mississippi and Ohio River valleys. […] In Minnesota, the incidence appears higher in southern and western Minnesota, but cases have been reported from across the state. […] In 2018, there were 57 confirmed cases and 127 probable cases of histoplasmosis in Minnesota, compared to 36 confirmed cases and 147 probable cases in 2017. […] Healthcare providers and clinical laboratories are required to report cases to the Minnesota Department of Health.

• #49 CSTE Histoplasmosis Position Statement

  https://miravistalabs.com/cste-histoplasmosis-position-statement/

  CSTE approved the Infectious Disease Committee’s revisions to the histoplasmosis position statement, “Standardized Surveillance Case Definition for Histoplasmosis” at the organization’s annual conference in Anchorage, Alaska on June 19-23, 2016. […] CSTE works to advance public health policy and epidemiologic capacity. The organization also provides information, education, and developmental support of practicing epidemiologists in a wide range of areas as well as expertise for program and surveillance efforts. […] CSTE supports effective public health surveillance and good epidemiologic practice through training, capacity development, and peer consultation.

• #50 Evolving Epidemiology, Improving Diagnostic Tests and Their Importance for the Correct Diagnosis of Histoplasmosis

  https://www.mdpi.com/2309-608X/11/3/196

  Histoplasmosis has traditionally been described as having discrete geographic areas of endemicity. […] Our understanding of where histoplasmosis occurs has improved in recent years due to improving access to diagnostic testing and increased reporting as well as larger at-risk populations (HIV and non-HIV immune suppression) resulting in more cases. […] At present, the data are telling us that histoplasmosis is occurring in most parts of the world but is particularly common in much of North America, South and Central America, as well as large parts of Africa and to a lesser degree (so far) Europe, Asia, Australia, and even Antarctica. […] In Latin America, the lack of surveillance of fungal infections in many countries has contributed to lack of the recognition of the true prevalence of this mycosis.

• #51 Histoplasmosis: Epidemiology in Latin America

  https://repository.urosario.edu.co/handle/10336/23804

  Histoplasmosis is a frequent health problem in Latin American countries, but the fact that it is not a reportable disease prevents reliable estimates of its real incidence and impact on public health. […] Epidemiologic and clinical data remain patchy in general, and in some countries the information available is very limited. […] Histoplasmosis has a significant public health impact in susceptible populations such as immunosuppressed individuals, in whom the disease is associated with poor outcomes. […] Limited availability of diagnostic tools in many regions of Latin America is an additional problem, as many patients are already severely ill by the time of the diagnosis. […] Efforts are therefore necessary to ensure early diagnosis and appropriate treatment, limit the severity of the disease manifestations, and reduce morbidity and mortality. […] This paper reviews important aspects of the epidemiology of histoplasmosis, the most clinically significant endemic mycosis in Latin America.

• #52 SciELO Brazil – Acute pulmonary histoplasmosis: a case series from an outbreak in Southeastern Brazil Acute pulmonary histoplasmosis: a case series from an outbreak in Southeastern Brazil

  https://www.scielo.br/j/rimtsp/a/R3mqN5RjV8v4qbMNjk6dRpj/

  Histoplasmosis is a systemic mycosis prevalent in the Americas. […] The actual incidence of histoplasmosis is unknown, owing to the fact that most of the studies carried out on the subject are limited to regions affected by outbreaks of the disease. […] Occupational exposures are frequently implicated in histoplasmosis outbreaks. […] In our series of cases, the evidence of the outbreak was fundamental to establish the epidemiological diagnosis of the acute pulmonary disease, associated with radiological images suggestive of histoplasmosis. […] Although histoplasmosis is not in the national list of compulsory notification diseases in Brazil, the Rio de Janeiro State recommended it in a recent local list, considering the local epidemiological profile and need to improve surveillance of systemic mycoses. […] Early diagnostic suspicion and adequate treatment of acute pulmonary forms of histoplasmosis can prevent fatal outcomes.

• #53 Epidemiological Survey on Histoplasmosis – ECMM

  https://www.ecmm.info/working-groups/epidemiological-survey-histoplasmosis/

  The ECMM survey on histoplasmosis in Europe was set up in March 1997 to examine the epidemiology of this disease in Europe. It aimed to assess how frequently histoplasmosis occurred in Europe, where and how the infection was acquired, groups at risk, the causative organism, the methods by which the infection was diagnosed and what therapy patients received. […] Overall, 127 cases were reported, with 70 occurring in the retrospective phase of the survey and 57 during the prospective phase. […] The number of cases reported from each country varied significantly and this is thought to be due to the ways in which the disease was diagnosed. […] Because primary pulmonary histoplasmosis is often self-limiting, most cases will go undiagnosed and so the cases reported in the survey are likely to represent the tip of the iceberg.

• #54 Facts and Stats About Histoplasmosis | Histoplasmosis | CDC

  https://www.cdc.gov/histoplasmosis/php/statistics/index.html

  Histoplasmosis is not a nationally reportable disease. […] The average annual incidence is between 1 to 2 cases per 100,000 population. […] Among states where histoplasmosis is reportable, average annual incidence is between 1 to 2 cases per 100,000 population. However, state-specific annual incidence ranges from 0 to 7 cases per 100,000 population according to recent surveillance data. […] Death rates are generally around 5%, though higher rates among adults have been reported. […] Among people who are hospitalized with histoplasmosis, death rates generally range from 5% to 7%. […] The overall mortality rate for histoplasmosis is likely lower than these estimates because these studies did not include patients who had less severe forms of the infection.

• #55 Histoplasma/Histoplasmosis | Concise Medical Knowledge

  https://www.lecturio.com/concepts/histoplasma-histoplasmosis/

  Most common fungal infection endemic in the US […] Incidence in the US: 1 to 2 cases per 100,000 population […] US: high exposure in Mississippi/Ohio River valleys (60-90% lifetime exposure in these regions) […] Outcomes can vary depending on severity, duration, and host immune state […] Mild disease: typically good outcomes […] Mortality of severe disease (despite hospitalization): 5% in children, 8% in adults […] Chronic pulmonary histoplasmosis is more likely in individuals with underlying lung disease (particularly emphysema) […] Disseminated histoplasmosis: Immunocompetent adults: 1 per 2,000 cases of histoplasmosis […] Immunocompromised individuals: 4%-27% mortality in severe cases.

• #56 Disseminated histoplasmosis – Life Worldwide

  https://en.fungaleducation.org/disseminated-histoplasmosis/

  Histoplasma capsulatum is endemic to much of Africa and Latin America, as well as the mid-Western US and Southeast Asia. […] The global number of disseminated histoplasmosis cases in AIDS worldwide has been estimated to be 100,000 annually. […] The gold standard is a Histoplasma antigen test in urine, which is positive in 90% of cases. […] The treatment of choice is 3 mg/kg intravenous liposomal amphotericin B (AmBisome) for 2 weeks, followed by itraconazole 200-400 mg daily, assuming no drug interaction with rifampicin. […] Overall mortality of PDH is 85-100% without treatment, and reduced to 25% with treatment. Around 80,000 deaths annually are predicted when using the most conservative estimates available. […] Exposure is common in the areas in which histoplasmosis is endemic but symptomatic disease is uncommon. […] The organism thrives in bat and bird guano. The larger the inoculum, the more severe the illness.

• #57 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The distribution of these cases extends beyond the originally defined boundaries of the US river valleys, encompassing states in the north (Minnesota, Wisconsin, Michigan), northeast (New York), and west (California, Arizona, Idaho, and Montana). […] In Canada, histoplasmosis is considered endemic in the regions adjacent to the St. Lawrence River and the Great Lakes, especially Quebec and Ontario. […] Histoplasmosis is endemic in Central and South America, excepting the western part of the two continents (west Mexico and Peru, and most of Chile). […] Histoplasmosis is an increasing challenge for the Latin American population, especially the disseminated form of the disease occurring in HIV-positive patients. […] In a large prospective cohort study, conducted in Guatemala between 2005 and 2009, which enrolled HIV-positive patients with suspected histoplasmosis, crude mortality in patients with histoplasmosis was 43.6 versus 30.8% among no-histoplasmosis patients.

• #58 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  A robust study of more than 58% of the newly diagnosed HIV patients, reported by the national HIV program during 2017-2018, in Guatemala found that histoplasmosis was the most common opportunistic infection, with an overall incidence of 7.9%. […] The prognosis of disseminated histoplasmosis in Africa is poor, fatality rates varying between 23% for H. capsulatum var. duboisii and 50% for H. capsulatum var. capsulatum infections. […] In Europe, the disease is rarely reported and is considered a predominantly imported disease. […] The majority of cases are linked to travel in endemic areas or immigration. […] In conclusion, doctors from non-endemic areas must consider in certain cases the differential diagnosis with histoplasmosis in immunosuppressed patients and especially in those with HIV infection, because early diagnosis and rapid institution of therapy improve the outcome of the disease and patients survival.

• #59 Evolving Epidemiology, Improving Diagnostic Tests and Their Importance for the Correct Diagnosis of Histoplasmosis

  https://www.mdpi.com/2309-608X/11/3/196

  In 2017, the total estimated annual incidence of histoplasmosis was ~100,000 cases worldwide. […] The mortality rate was 40% in PLWHA with LT-CD4+ < 200 cells/μL, resulting in 9600 deaths per year from histoplasmosis, more than from tuberculosis (~6000 deaths) in Latin America. [...] The United States is a highly endemic country for histoplasmosis, with very high rates in the Mississippi and Ohio Valley regions but also with cases being reported throughout much of the country. [...] Between 2001 and 2006, 15 centers of the Transplant-Associated Infection Surveillance Network registered 52 cases of histoplasmosis, of which 48 occurred in solid organ transplant recipients and 4 in hematopoietic cell recipients. [...] Africa has seen a steady rise in the number of histoplasmosis cases reported following an increase in medical mycology advocacy and clinician sensitization to the presence of a number of fungal infections.

• #60 Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis — United States, 2019 | MMWR

  https://www.cdc.gov/mmwr/volumes/71/ss/ss7107a1.htm

  In 2019, a total of 20,061 confirmed coccidioidomycosis, 1,124 confirmed and probable histoplasmosis, and 240 confirmed and probable blastomycosis cases were reported to CDC. […] The national incidence of coccidioidomycosis, histoplasmosis, and blastomycosis is poorly characterized. […] Improved surveillance is necessary to better characterize coccidioidomycosis severity and to improve detection of histoplasmosis and blastomycosis. […] Public health response to these three diseases is hindered because information gathered from states routine surveillance does not include data on populations at risk and sources of exposure. […] National surveillance of coccidioidomycosis, histoplasmosis, and blastomycosis can be improved and expanded to include more states and data elements. […] High mortality and hospitalization rates for histoplasmosis and blastomycosis suggest underreporting of mild and severe disease while highlighting their severe clinical outcomes. […] Improved and expanded surveillance would allow a more robust public health response to these diseases.

• #61 Occupational Histoplasmosis: Epidemiology and Prevention Measures

  https://www.mdpi.com/2309-608X/7/7/510

  Work-related histoplasmosis can occur in various settings. […] To improve data collection in surveillance systems, the NIOSH Surveillance Program at the Centers for Disease Control and Prevention (CDC) recommends that occupational questions should be standardized, information on both industry and occupation should be collected, and data should be analyzed with standard coding schemes to monitor disease trends in specific industries or occupations and protect workers’ health. […] Communication and cooperation between clinicians and public health practitioners is important to identify work-related clusters of histoplasmosis.

• #62

  https://journals.lww.com/epidem/fulltext/2022/09000/integrating_public_health_surveillance_and.8.aspx

  Specifically, the high probability of histoplasmosis detection in Minnesota is consistent with previous work and may reflect a strong surveillance system and a broad case definition at the time the data were collected. […] We have illustrated how this modeling framework can be applied to public health data to quantify spatial variability and identify geographic regions of increased risk. […] A more comprehensive characterization of its spatial distribution is important for guiding clinical decision-making and public health surveillance and prevention activities.

• #63 Occupational Histoplasmosis: Epidemiology and Prevention Measures

  https://www.mdpi.com/2309-608X/7/7/510

  Work-related histoplasmosis can occur in various settings. […] To improve data collection in surveillance systems, the NIOSH Surveillance Program at the Centers for Disease Control and Prevention (CDC) recommends that occupational questions should be standardized, information on both industry and occupation should be collected, and data should be analyzed with standard coding schemes to monitor disease trends in specific industries or occupations and protect workers’ health. […] Communication and cooperation between clinicians and public health practitioners is important to identify work-related clusters of histoplasmosis.

• #64

  https://journals.lww.com/epidem/fulltext/2022/09000/integrating_public_health_surveillance_and.8.aspx

  Specifically, the high probability of histoplasmosis detection in Minnesota is consistent with previous work and may reflect a strong surveillance system and a broad case definition at the time the data were collected. […] We have illustrated how this modeling framework can be applied to public health data to quantify spatial variability and identify geographic regions of increased risk. […] A more comprehensive characterization of its spatial distribution is important for guiding clinical decision-making and public health surveillance and prevention activities.

• #65 Histoplasmosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448185/

  Histoplasmosis is the most common endemic mycosis in the United States. It is not a reportable disease. The presumed geographic distribution and endemicity are the Midwest and Southeastern regions of the United States. This information is largely derived from skin test surveys performed during the 1940s. Between 1938 through 2013 over 100 outbreaks involving approximately 3000 cases have been reported in 26 states and the territory of Puerto Rico. In the above publication, an outbreak was defined as two or more cases. Common exposure settings were chicken coops or construction projects. Birds, bats, or their droppings were reported to be present in 77% of the outbreak settings, and workplace exposures were reported in half of the outbreaks. In endemic regions and sporadic cases, the exact exposure is difficult to pinpoint, as frequently symptoms are due to reactivation of the disease.

• #66 Histoplasmosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448185/

  Histoplasmosis is the most common endemic mycosis in the United States. It is not a reportable disease. The presumed geographic distribution and endemicity are the Midwest and Southeastern regions of the United States. This information is largely derived from skin test surveys performed during the 1940s. Between 1938 through 2013 over 100 outbreaks involving approximately 3000 cases have been reported in 26 states and the territory of Puerto Rico. In the above publication, an outbreak was defined as two or more cases. Common exposure settings were chicken coops or construction projects. Birds, bats, or their droppings were reported to be present in 77% of the outbreak settings, and workplace exposures were reported in half of the outbreaks. In endemic regions and sporadic cases, the exact exposure is difficult to pinpoint, as frequently symptoms are due to reactivation of the disease.

• #67

  http://www.jornaldepneumologia.com.br/details/1590/en-US/an-outbreak-of-histoplasmosis-in-the-city-of-blumenau–santa-catarina;

  Acute pulmonary histoplasmosis is rarely diagnosed and is often confused with tuberculosis. Most knowledge of the disease has been derived from descriptions of epidemics in which a number of individuals were exposed to the same source of infection. Isolation of Histoplasma capsulatum var. capsulatum from soil samples is conclusive evidence of an epidemic focus. This is the first report of an outbreak of histoplasmosis, in which two cases were reported and the fungus was isolated at the focus of the epidemic, in the state of Santa Catarina. Further epidemiological studies are needed in order to determine the prevalence of the infection statewide. […] In Brazil, 26 outbreaks of histoplasmosis, involving 184 patients, have been reported since 1958. The number of cases per outbreak ranged from two to thirteen. The main sources of infection were visits to caves where there was bat guano (ten outbreaks), followed by visits to abandoned mines (five), and contact with droppings from chicken coops (three outbreaks). In 11 of those outbreaks, H. capsulatum was isolated from soil.

• #68

  http://www.jornaldepneumologia.com.br/details/1590/en-US/an-outbreak-of-histoplasmosis-in-the-city-of-blumenau–santa-catarina;

  The present study represents the first time that it was possible to isolate H. capsulatum from soil in the state of Santa Catarina, this being conclusive evidence of an epidemic focus. […] Outbreaks of histoplasmosis are usually more frequent in areas of higher endemicity. Further epidemiological studies are needed in order to determine the prevalence of the infection statewide.

• #69

  http://www.jornaldepneumologia.com.br/details/1590/en-US/an-outbreak-of-histoplasmosis-in-the-city-of-blumenau–santa-catarina;

  Acute pulmonary histoplasmosis is rarely diagnosed and is often confused with tuberculosis. Most knowledge of the disease has been derived from descriptions of epidemics in which a number of individuals were exposed to the same source of infection. Isolation of Histoplasma capsulatum var. capsulatum from soil samples is conclusive evidence of an epidemic focus. This is the first report of an outbreak of histoplasmosis, in which two cases were reported and the fungus was isolated at the focus of the epidemic, in the state of Santa Catarina. Further epidemiological studies are needed in order to determine the prevalence of the infection statewide. […] In Brazil, 26 outbreaks of histoplasmosis, involving 184 patients, have been reported since 1958. The number of cases per outbreak ranged from two to thirteen. The main sources of infection were visits to caves where there was bat guano (ten outbreaks), followed by visits to abandoned mines (five), and contact with droppings from chicken coops (three outbreaks). In 11 of those outbreaks, H. capsulatum was isolated from soil.

• #70 SciELO Brazil – Acute pulmonary histoplasmosis: a case series from an outbreak in Southeastern Brazil Acute pulmonary histoplasmosis: a case series from an outbreak in Southeastern Brazil

  https://www.scielo.br/j/rimtsp/a/R3mqN5RjV8v4qbMNjk6dRpj/

  Histoplasmosis is a systemic mycosis prevalent in the Americas. […] The actual incidence of histoplasmosis is unknown, owing to the fact that most of the studies carried out on the subject are limited to regions affected by outbreaks of the disease. […] Occupational exposures are frequently implicated in histoplasmosis outbreaks. […] In our series of cases, the evidence of the outbreak was fundamental to establish the epidemiological diagnosis of the acute pulmonary disease, associated with radiological images suggestive of histoplasmosis. […] Although histoplasmosis is not in the national list of compulsory notification diseases in Brazil, the Rio de Janeiro State recommended it in a recent local list, considering the local epidemiological profile and need to improve surveillance of systemic mycoses. […] Early diagnostic suspicion and adequate treatment of acute pulmonary forms of histoplasmosis can prevent fatal outcomes.

• #71 SciELO Brazil – Acute pulmonary histoplasmosis: a case series from an outbreak in Southeastern Brazil Acute pulmonary histoplasmosis: a case series from an outbreak in Southeastern Brazil

  https://www.scielo.br/j/rimtsp/a/R3mqN5RjV8v4qbMNjk6dRpj/

  Histoplasmosis is a systemic mycosis prevalent in the Americas. […] The actual incidence of histoplasmosis is unknown, owing to the fact that most of the studies carried out on the subject are limited to regions affected by outbreaks of the disease. […] Occupational exposures are frequently implicated in histoplasmosis outbreaks. […] In our series of cases, the evidence of the outbreak was fundamental to establish the epidemiological diagnosis of the acute pulmonary disease, associated with radiological images suggestive of histoplasmosis. […] Although histoplasmosis is not in the national list of compulsory notification diseases in Brazil, the Rio de Janeiro State recommended it in a recent local list, considering the local epidemiological profile and need to improve surveillance of systemic mycoses. […] Early diagnostic suspicion and adequate treatment of acute pulmonary forms of histoplasmosis can prevent fatal outcomes.

• #72 Occupational Histoplasmosis: Epidemiology and Prevention Measures

  https://www.mdpi.com/2309-608X/7/7/510

  In areas where Histoplasma is endemic in the environment, occupations involving activities exposing workers to soil that contains bird or bat droppings may pose a risk for histoplasmosis. Occupational exposures are frequently implicated in histoplasmosis outbreaks. […] People in these areas are at risk for inhaling Histoplasma from the environment, especially those who have occupations or participate in activities exposing them to soil that contains bird or bat droppings. Occupational exposures are frequently implicated in histoplasmosis outbreaks. […] In this paper, we review the literature on occupationally acquired histoplasmosis. We describe the epidemiology in the United States, occupational risk factors, and prevention measures according to the hierarchy of controls. […] Understanding the geographic distribution of histoplasmosis is helpful in targeting prevention and control measures.

• #73

  https://www.who.int/publications/i/item/9789240006430

  Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. […] Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 515% of AIDS-related deaths every year in this Region. […] Although the burden of disease is concentrated in the Americas, the recommendations presented within these guidelines are applicable globally.

• #74 Histoplasmosis: Epidemiology in Latin America

  https://repository.urosario.edu.co/handle/10336/23804

  Histoplasmosis is a frequent health problem in Latin American countries, but the fact that it is not a reportable disease prevents reliable estimates of its real incidence and impact on public health. […] Epidemiologic and clinical data remain patchy in general, and in some countries the information available is very limited. […] Histoplasmosis has a significant public health impact in susceptible populations such as immunosuppressed individuals, in whom the disease is associated with poor outcomes. […] Limited availability of diagnostic tools in many regions of Latin America is an additional problem, as many patients are already severely ill by the time of the diagnosis. […] Efforts are therefore necessary to ensure early diagnosis and appropriate treatment, limit the severity of the disease manifestations, and reduce morbidity and mortality. […] This paper reviews important aspects of the epidemiology of histoplasmosis, the most clinically significant endemic mycosis in Latin America.

• #75 Epidemiology of Histoplasmosis | IntechOpen

  https://www.intechopen.com/chapters/86816

  The real burden of the disease seems to be underestimated because it is frequently misdiagnosed as tuberculosis, community-acquired pneumonia or other acute lower respiratory tract infections, and underdiagnosed due to poor availability of diagnostic tests. […] Recent global estimates found almost 500,000 cases of histoplasmosis and approximately 100,000 cases of disseminated histoplasmosis occurring annually. […] The geographic distribution of H. capsulatum in North America remains still unclear and requires further investigations. […] In highly endemic areas around the US river valleys, population skin delayed type hypersensitivity to histoplasmin is around 90%, meaning that residents of these areas were exposed to the primary infection at some point in their lifetime. […] Epidemiological reports and studies have shown many cases of histoplasmosis diagnosed in humans or animals outside historically recognized endemic areas.

• #76 Histoplasmosis: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/histoplasmosis

  Data from a prospective, randomized, controlled trial indicate that itraconazole can reduce the incidence of histoplasmosis, although not mortality, in people who have advanced HIV (CD4 counts 150 cells/mm3) and live in areas where histoplasmosis is highly endemic. Based on these data, the Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV (the Panel) continues to recommend itraconazole at a dose of 200 mg daily as primary prophylaxis to people with CD4 counts 150 cells/mm3 who are at high risk because of occupational histoplasmosis exposure or who live in a community with a hyperendemic rate of histoplasmosis (10 cases/100 person-years).

• #77 Histoplasmosis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/histoplasmosis.html

  The fungus is found throughout the world and grows in soil that has been enriched with bat or bird droppings or in bat droppings themselves. […] The disease is not spread from person to person. It is not acquired from animals that have the disease. […] The following steps can be taken to reduce exposure to Histoplasma capsulatum: prevent bats and birds from entering buildings to prevent the buildup of droppings, avoid areas that may harbor the fungus, particularly those areas with accumulations of bird or bat droppings. […] Large accumulations of bird or bat droppings should be removed by a professional cleanup and restoration firm experienced with hazardous waste disposal.

• #78 Epidemiology of Histoplasmosis

  https://ouci.dntb.gov.ua/en/works/4rN5ZpJ4/

  Epidemiology of histoplasmosis. […] More prevalent than initially considered, histoplasmosis is primarily a non-contagious disease of the reticuloendothelial system, producing a broad spectrum of clinical manifestations, ranging from asymptomatic or self-limited infection, in immunocompetent patients to life-threatening, disseminated disease in immunocompromised ones. […] Since then, histoplasmosis was described on six continents, with high and low endemicity areas. […] In endemic areas, patients with AIDS or people who receive immunosuppressive therapies should be counseled to avoid high-risk activities; otherwise, precautionary measures should be taken. […] Scully MC, Baddley JW. Epidemiology of histoplasmosis. Current Fungal Infection Reports. 2018;12:51-58. DOI: 10.1007/s12281-018-0309-x DOI: 10.1007/s12281-018-0309-x

• #79 Epidemiology and Knowledge Gap of Histoplasmosis in Africa | IntechOpen

  https://www.intechopen.com/chapters/87565

  Thus, there is a general knowledge gap among health workers in Africa to diagnose histoplasmosis. […] Pulmonary histoplasmosis could be mostly misdiagnosed as pulmonary tuberculosis since it presents with similar clinical presentations. […] Because histoplasmosis and tuberculosis (TB) present clinically similarly, some misdiagnoses may occur due to a lack of diagnostic resources. […] Despite not being on the World Health Organizations official list, Hcd histoplasmosis is regarded as a neglected tropical illness. […] The general lack of expertise in Africa to skillfully diagnose histoplasmosis makes it difficult to accurately diagnose histoplasmosis. […] There is an urgent need for more precise and user-friendly diagnostic tools to confirm diagnoses and distinguish between Hcd and Hcc disorders, both of which are prevalent on the African continent. […] Most of Africas health national health systems are incapacitated to diagnose histoplasmosis due to a lack of expertise and diagnostic technologies, thus causing miss diagnosis of the same disease.

• #80 Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis — United States, 2019 | MMWR

  https://www.cdc.gov/mmwr/volumes/71/ss/ss7107a1.htm

  In 2019, a total of 20,061 confirmed coccidioidomycosis, 1,124 confirmed and probable histoplasmosis, and 240 confirmed and probable blastomycosis cases were reported to CDC. […] The national incidence of coccidioidomycosis, histoplasmosis, and blastomycosis is poorly characterized. […] Improved surveillance is necessary to better characterize coccidioidomycosis severity and to improve detection of histoplasmosis and blastomycosis. […] Public health response to these three diseases is hindered because information gathered from states routine surveillance does not include data on populations at risk and sources of exposure. […] National surveillance of coccidioidomycosis, histoplasmosis, and blastomycosis can be improved and expanded to include more states and data elements. […] High mortality and hospitalization rates for histoplasmosis and blastomycosis suggest underreporting of mild and severe disease while highlighting their severe clinical outcomes. […] Improved and expanded surveillance would allow a more robust public health response to these diseases.

• #81 Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis — United States, 2019 | MMWR

  https://www.cdc.gov/mmwr/volumes/71/ss/ss7107a1.htm

  In 2019, a total of 20,061 confirmed coccidioidomycosis, 1,124 confirmed and probable histoplasmosis, and 240 confirmed and probable blastomycosis cases were reported to CDC. […] The national incidence of coccidioidomycosis, histoplasmosis, and blastomycosis is poorly characterized. […] Improved surveillance is necessary to better characterize coccidioidomycosis severity and to improve detection of histoplasmosis and blastomycosis. […] Public health response to these three diseases is hindered because information gathered from states routine surveillance does not include data on populations at risk and sources of exposure. […] National surveillance of coccidioidomycosis, histoplasmosis, and blastomycosis can be improved and expanded to include more states and data elements. […] High mortality and hospitalization rates for histoplasmosis and blastomycosis suggest underreporting of mild and severe disease while highlighting their severe clinical outcomes. […] Improved and expanded surveillance would allow a more robust public health response to these diseases.

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