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Blastomycosis: A Rare Fungal Disease Showing Increased Areas of Endemicity

A study published recently in Emerging Infectious Diseases revealed that blastomycosis, a rare and potentially fatal fungal disease, might have far-reaching endemic locations than previously recognized. Blastomycosis is caused by an environmental fungus called Blastomyces, commonly found in damp soil and decomposing organic materials. Though most individuals exposed to its spores don’t fall ill, the disease exhibits pneumonia-like symptoms in some cases and can lead to severe illness, boasting a mortality rate as high as 22%. Traditionally, blastomycosis has been deemed endemic within regions along the Ohio and Mississippi rivers, the Great Lakes, and the St. Lawrence Seaway, with projected annual incidences ranging from 0.2 to 2.0 cases per 100,000 people.

However, the formality of public health surveillance only extends to Arkansas, Louisiana, Minnesota, Michigan, and Wisconsin. The research team, consisting of professionals from the CDC and Vermont Health Department, used data from the state’s all-payer health insurance claims to unveil 114 patients diagnosed with blastomycosis from 2011 to 2020. This mean annual statewide incidence, 1.8 cases per 100,000 individuals, outmatched the mean annual rates in most states where reporting is mandated and surpassed incidences reported in three other states located in known endemic regions.

Of the 114 patients studied, 30 experienced hospitalization due to blastomycosis-related complications, and four succumbed to the disease. The researchers point out that expanded surveillance of blastomycosis is essential, challenging assumptions about the disease’s epidemiology and ecology and advocating for further studies. They recommended clinicians consider blastomycosis among possible diagnoses for patients with corresponding symptoms.


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