A large outbreak of histoplasmosis among American travelers associated with a hotel in Acapulco, Mexico, spring 2001

被引:36
作者
Morgan, J
Cano, MV
Feikin, DR
Phelan, M
Monroy, OV
Morales, PK
Carpenter, J
Weltman, A
Spitzer, PG
Liu, HH
Mirza, SA
Bronstein, DE
Morgan, DJ
Kirkman, LA
Brandt, ME
Iqbal, N
Lindsley, MD
Warnock, DW
Hajjeh, RA
机构
[1] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Resp Dis Branch, Atlanta, GA 30333 USA
[2] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Biostat & Informat Management Branch, Div Bacterial & Mycot Dis, Atlanta, GA 30333 USA
[3] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Healthcare Qual Promot, Atlanta, GA 30333 USA
[4] Minist Hlth, Dept Epidemiol, Mexico City, DF, Mexico
[5] Penn Dept Hlth, Harrisburg, PA 17108 USA
[6] Bryn Mawr Med Specialists, Bryn Mawr, PA USA
[7] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Mycot Dis Branch, Atlanta, GA 30333 USA
关键词
D O I
10.4269/ajtmh.2003.69.663
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
During spring 2001, college students from Pennsylvania reported an acute febrile respiratory illness after returning from spring break vacation in Acapulco, Mexico. Acute pulmonary histoplasmosis was presumptively diagnosed and the cluster of illness was reported to the Centers of Disease Control and Prevention. A large investigation then ensued, which included finding student-travelers for interviews and requesting sera for histoplasmosis testing. We defined a clinical case by fever and at least one of the following: cough, shortness of breath, chest pain, or headache, in an Acapulco traveler during March-May 2001. A laboratory-confirmed case had positive serology. An initial study determined that the likely site of histoplasmosis exposure was Hotel H; we therefore performed a large cohort study among travelers who stayed at Hotel H. Of 757 contacted, 262 (36%) met the clinical case definition. Of 273 serum specimens tested, 148 (54%) were positive. Frequent use of Hotel H's stairwells, where construction was ongoing, was associated with increased risk of illness (relative risk = 10.5, 95% confidence interval = 3.7-30.5; P < 0.001). This is the first histoplasmosis outbreak associated with a hotel undergoing construction. Hotels in endemic areas should consider construction precaution measures to prevent histoplasmosis among their guests.
引用
收藏
页码:663 / 669
页数:7
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