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Volume 24, Number 7—July 2018
CME ACTIVITY - Research

Epidemiology and Geographic Distribution of Blastomycosis, Histoplasmosis, and Coccidioidomycosis, Ontario, Canada, 1990–2015

Elizabeth M. Brown1, Lisa R. McTaggart1, Deirdre Dunn, Elizabeth Pszczolko, Kar George Tsui, Shaun K. Morris, Derek Stephens, Julianne V. Kus2Comments to Author , and Susan E. Richardson2
Author affiliations: Public Health Ontario, Toronto, Ontario, Canada (E.M. Brown, L.R. McTaggart, D. Dunn, E. Pszczolko, K.G. Tsui, J.V. Kus, S.E. Richardson); University of Toronto, Toronto (E.M. Brown, S.K. Morris, J.V. Kus, S.E. Richardson); The Hospital for Sick Children, Toronto (S.K. Morris, D. Stephens, S.E. Richardson)

Main Article

Figure 1

Geographic distribution of A) annualized incidence (no. cases/100,000 population) of blastomycosis (1995–2015) and B) no. cases of histoplasmosis (1990–2015) by Ontario Local Health Integration Network (LHIN), Ontario, Canada. 1, Erie St. Clair; 2, South West; 3, Waterloo Wellington; 4, Hamilton Niagara Haldimond Brant; 5, Central West; 6, Mississauga Halton; 7, Toronto Central; 8, Central; 9, Central East; 10, South East; 11, Champlain; 12, North Simcoe Muskoka; 13, North East; 14, North West.

Figure 1. Geographic distribution of A) annualized incidence (no. cases/100,000 population) of blastomycosis (1995–2015) and B) no. cases of histoplasmosis (1990–2015) by Ontario Local Health Integration Network (LHIN), Ontario, Canada. 1, Erie St. Clair; 2, South West; 3, Waterloo Wellington; 4, Hamilton Niagara Haldimond Brant; 5, Central West; 6, Mississauga Halton; 7, Toronto Central; 8, Central; 9, Central East; 10, South East; 11, Champlain; 12, North Simcoe Muskoka; 13, North East; 14, North West. Incidence was calculated using LHIN-specific population denominators from Statistics Canada (36). Inset shows the location of Ontario within North America.

Main Article

References
  1. Benedict  K, Thompson  GR III, Deresinski  S, Chiller  T. Mycotic infections acquired outside areas of known endemicity, United States. Emerg Infect Dis. 2015;21:193541. DOIPubMedGoogle Scholar
  2. Pfaller  MA, Diekema  DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol. 2010;36:153. DOIPubMedGoogle Scholar
  3. Centers for Disease Control and Prevention. Reportable fungal diseases by state. 6 Mar 2017 [cited 2017 Sep 7]. https://www.cdc.gov/fungal/fungal-disease-reporting-table.html
  4. Morris  SK, Brophy  J, Richardson  SE, Summerbell  R, Parkin  PC, Jamieson  F, et al. Blastomycosis in Ontario, 1994-2003. Emerg Infect Dis. 2006;12:2749. DOIPubMedGoogle Scholar
  5. Dalcin  D, Ahmed  SZ. Blastomycosis in northwestern Ontario, 2004 to 2014. Can J Infect Dis Med Microbiol. 2015;26:25962. DOIPubMedGoogle Scholar
  6. Dwight  PJ, Naus  M, Sarsfield  P, Limerick  B. An outbreak of human blastomycosis: the epidemiology of blastomycosis in the Kenora catchment region of Ontario, Canada. Can Commun Dis Rep. 2000;26:8291.PubMedGoogle Scholar
  7. Roy  M, Benedict  K, Deak  E, Kirby  MA, McNiel  JT, Sickler  CJ, et al. A large community outbreak of blastomycosis in Wisconsin with geographic and ethnic clustering. Clin Infect Dis. 2013;57:65562. DOIPubMedGoogle Scholar
  8. Enoch  DA, Yang  H, Aliyu  SH, Micallef  C. The changing epidemiology of invasive fungal infections. Methods Mol Biol. 2017;1508:1765. DOIPubMedGoogle Scholar
  9. Litvintseva  AP, Marsden-Haug  N, Hurst  S, Hill  H, Gade  L, Driebe  EM, et al. Valley fever: finding new places for an old disease: Coccidioides immitis found in Washington State soil associated with recent human infection. Clin Infect Dis. 2015;60:e13. DOIPubMedGoogle Scholar
  10. Pfaff  BL, Agger  WA, Volk  TJ. Blastomycosis diagnosed in a nonhyperendemic area. WMJ. 2014;113:11, 8; quiz 19. PubMedGoogle Scholar
  11. Greer  A, Ng  V, Fisman  D. Climate change and infectious diseases in North America: the road ahead. CMAJ. 2008;178:71522.PubMedGoogle Scholar
  12. Chu  JH, Feudtner  C, Heydon  K, Walsh  TJ, Zaoutis  TE. Hospitalizations for endemic mycoses: a population-based national study. [</jrn>]. Clin Infect Dis. 2006;42:8225 . https://doi.org/10.1086/500405PubMedGoogle Scholar
  13. Centers for Disease Control and Prevention (CDC). Increase in reported coccidioidomycosis—United States, 1998-2011. MMWR Morb Mortal Wkly Rep. 2013;62:21721.PubMedGoogle Scholar
  14. Seitz  AE, Younes  N, Steiner  CA, Prevots  DR. Incidence and trends of blastomycosis-associated hospitalizations in the United States. PLoS One. 2014;9:e105466. DOIPubMedGoogle Scholar
  15. Baddley  JW, Winthrop  KL, Patkar  NM, Delzell  E, Beukelman  T, Xie  F, et al. Geographic distribution of endemic fungal infections among older persons, United States. Emerg Infect Dis. 2011;17:16649. DOIPubMedGoogle Scholar
  16. Benedict  K, Mody  RK. Epidemiology of histoplasmosis outbreaks, United States, 1938–2013. Emerg Infect Dis. 2016;22:3708. DOIPubMedGoogle Scholar
  17. Luo  R, Greenberg  A, Stone  CD. Hospitalized burden and outcomes of coccidioidomycosis: A nationwide analysis, 2005-2012. Med Mycol. 2017;55:36874.PubMedGoogle Scholar
  18. Lee  PP, Lau  YL. Cellular and molecular defects underlying invasive fungal infections—revelations from endemic mycoses. Front Immunol. 2017;8:735. DOIPubMedGoogle Scholar
  19. Nicolle  L, Rotstein  C, Bourgault  A, St-Germain  G, Garber  G; Canadian Infectious Diseases Society Invasive Fungal Registry. Invasive fungal infections in Canada from 1992 to 1994. Can J Infect Dis. 1998;9:34752. DOIPubMedGoogle Scholar
  20. Kane  J, Righter  J, Krajden  S, Lester  RS. Blastomycosis: a new endemic focus in Canada. Can Med Assoc J. 1983;129:72831.PubMedGoogle Scholar
  21. Crampton  TL, Light  RB, Berg  GM, Meyers  MP, Schroeder  GC, Hershfield  ES, et al. Epidemiology and clinical spectrum of blastomycosis diagnosed at Manitoba hospitals. Clin Infect Dis. 2002;34:13106. DOIPubMedGoogle Scholar
  22. St-Germain  G, Murray  G, Duperval  R. Blastomycosis in Quebec (1981-90): Report of 23 cases and review of published cases from Quebec. Can J Infect Dis. 1993;4:8994. DOIPubMedGoogle Scholar
  23. Litvinjenko  S, Lunny  D. Blastomycosis hospitalizations in northwestern Ontario: 2006-2015. Can Commun Dis Rep. 2017;43:2005. DOIPubMedGoogle Scholar
  24. Population and public health branch. Summary of reportable diseases 1990. Toronto: Communicable Diseases Control, Ontario Ministry of Health; 1991.
  25. Lester  RS, DeKoven  JG, Kane  J, Simor  AE, Krajden  S, Summerbell  RC. Novel cases of blastomycosis acquired in Toronto, Ontario. CMAJ. 2000;163:130912.PubMedGoogle Scholar
  26. Litvinov  IV, St-Germain  G, Pelletier  R, Paradis  M, Sheppard  DC. Endemic human blastomycosis in Quebec, Canada, 1988-2011. Epidemiol Infect. 2013;141:11437. DOIPubMedGoogle Scholar
  27. Harasen  GL, Randall  JW. Canine blastomycosis in southern Saskatchewan. Can Vet J. 1986;27:3758.PubMedGoogle Scholar
  28. Brown  EL. Histoplasmosis in Southern Ontario: a further report. Can Med Assoc J. 1962;87:54551.PubMedGoogle Scholar
  29. Jessamine  AG, Macbeth  ME, Davies  JW. Histoplasmosis in eastern Ontario. Can J Public Health. 1966;57:1824.PubMedGoogle Scholar
  30. Bilgi  C. Pulmonary histoplasmosis: a review of 50 cases. Can Fam Physician. 1980;26:22530.PubMedGoogle Scholar
  31. Centers for Disease Control and Prevention (CDC). Histoplasmosis outbreak associated with the renovation of an old house - Quebec, Canada, 2013. MMWR Morb Mortal Wkly Rep. 2014;62:10414.PubMedGoogle Scholar
  32. Dufresne  P, Dufresne  S, Tremblay  C. St-Germain. Risk group 3 (RG3) mycoses in Quebec: a retrospective of documented cases (1988 to 2012). Presented at: Canadian Association for Clinical Microbiology and Infectious Diseases—Association of Medical Microbiology and Infectious Disease Canada 2013 Annual Conference; April 4–6, 2013; Quebec City, Quebec, Canada.
  33. Statistics Canada. Census datasets. 2017 Jul 14 [cited 2017 Sep 9]. http://www12.statcan.gc.ca/datasets/Index-eng.cfm
  34. Ontario Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Population estimates 2014–2015. Toronto: The Ministry; 2016
  35. Bruce Light  R, Kralt  D, Embil  JM, Trepman  E, Wiebe  L, Limerick  B, et al. Seasonal variations in the clinical presentation of pulmonary and extrapulmonary blastomycosis. Med Mycol. 2008;46:83541. DOIPubMedGoogle Scholar
  36. Statistics Canada. Health region boundary files. 2011 27 Nov [cited 2015 Apr 24]. http://www.statcan.gc.ca/pub/82-402-x/2011001/reg-eng.htm.
  37. Statistics Canada. 2016 census boundary files. 2017 Jan 16 [cited 2017 Sep 9]. http://www12.statcan.gc.ca/census-recensement/2011/geo/bound-limit/bound-limit-2016-eng.cfm
  38. Government of Ontario. Summary of proposed amendments to regulations made under the Health Protection and Promotion Act, December 12, 2017. 2017 Dec 29 [cited 2018 Feb 27]. http://www.ontariocanada.com/registry/showAttachment.do?postingId=25946&attachmentId=36128
  39. Klein  BS, Vergeront  JM, Weeks  RJ, Kumar  UN, Mathai  G, Varkey  B, et al. Isolation of Blastomyces dermatitidis in soil associated with a large outbreak of blastomycosis in Wisconsin. N Engl J Med. 1986;314:52934. DOIPubMedGoogle Scholar
  40. Northwestern Health Unit. Blastomycosis advisory: action required. 2017 Feb 16 [cited 2017 Sep 9]. https://www.nwhu.on.ca/Audiences/Documents/Health%20Information%20Advisory%20-%20Blastomycosis.pdf
  41. Sudbury and District Health Unit. Cluster of pediatric blastomycosis cases: advisory alert. 2017 Sep 9 [cited 2017 Oct 24]. https://www.sdhu.com/professionals/health-professionals/advisory-alerts-health-care-professionals/cluster-pediatric-blastomycosis-cases
  42. Minnesota Department of Health. Human blastomycosis cases in Minnesota by county of residence, 1999–2016, (n = 582). 2018 Feb 20 [cited 2018 Feb 27]. http://www.health.state.mn.us/divs/idepc/diseases/blastomycosis/humanblastores.pdf
  43. Baumgardner  DJ, Brockman  K. Epidemiology of human blastomycosis in Vilas County, Wisconsin. II: 1991-1996. WMJ. 1998;97:447.PubMedGoogle Scholar
  44. Bernstein  S, Brunner  HI, Summerbell  R, Allen  U, Babyn  P, Richardson  SE. Blastomycosis acquired by three children in Toronto. Can J Infect Dis. 2002;13:25963. DOIPubMedGoogle Scholar
  45. Bakerspigel  A, Kane  J, Schaus  D. Isolation of Blastomyces dermatitidis from an earthen floor in southwestern Ontario, Canada. J Clin Microbiol. 1986;24:8901.PubMedGoogle Scholar
  46. Chapman  SW. Blastomyces dermatitidis. In: Mandell GL, Bennell JE, Dolin R, editors. Principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier; 2005. p. 3026–40.
  47. Kauffman  CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20:11532. DOIPubMedGoogle Scholar
  48. Sekhon  AS, Isaac-Renton  J, Dixon  JM, Stein  L, Sims  HV. Review of human and animal cases of coccidioidomycosis diagnosed in Canada. Mycopathologia. 1991;113:110. DOIPubMedGoogle Scholar
  49. Cooksey  GS, Nguyen  A, Knutson  K, Tabnak  F, Benedict  K, McCotter  O, et al. Notes from the field: Increase in coccidioidomycosis—California, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:8334. DOIPubMedGoogle Scholar
  50. Bariola  JR, Perry  P, Pappas  PG, Proia  L, Shealey  W, Wright  PW, et al. Blastomycosis of the central nervous system: a multicenter review of diagnosis and treatment in the modern era. Clin Infect Dis. 2010;50:797804. DOIPubMedGoogle Scholar

Main Article

1These first authors contributed equally to this article.

2These senior responsible authors contributed equally to this article.

Page created: June 14, 2018
Page updated: June 14, 2018
Page reviewed: June 14, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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