ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013
A large community outbreak of blastomycosis in Wisconsin with geographic and ethnic clustering.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 91 citations in OpenAlex.
- Updating the Epidemiology of Blastomycosis and Histoplasmosis in the United States, Using National Electronic Health Record Data, 2013-2023.The Journal of infectious diseases · 2025Article
- Disseminated Blastomycosis: A Case of Multisite Infection in an Immunocompetent Patient.The American journal of case reports · 2025Article
- Human immunity to fungal infections.The Journal of experimental medicine · 2025Review
- Pulmonary Blastomycosis in Two Immunocompetent Patients: The Role of Obesity and Vitamin D Deficiency.Cureus · 2024Article
- Genomic Epidemiology of Large Blastomycosis Outbreak, Ontario, Canada, 2021.Emerging infectious diseases · 2024Article
- Clinical Presentation of Blastomycosis is Associated With Infecting Species, Not Host Genotype.Clinical medicine & research · 2024Article
- Social determinants of health as drivers of fungal disease.EClinicalMedicine · 2023Review
- Blastomycosis: A Review of Mycological and Clinical Aspects.Journal of fungi (Basel, Switzerland) · 2023Review
- Genitourinary Blastomycosis in a Young Male Patient: A Case Report and Review of Diagnostic Challenges.Case reports in infectious diseases · 2023Article
- Race and ethnicity: Risk factors for fungal infections?PLoS pathogens · 2023Review
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- Diagnostic Methods and Risk Factors for Severe Disease and Mortality in Blastomycosis: A Retrospective Cohort Study.Journal of fungi (Basel, Switzerland) · 2021Article
- An Unusual Case of Blastomycosis and Severe Lung Necrosis in a Hmong Woman With Preexisting Liver Cirrhosis.Cureus · 2021Article
- Clinical Manifestations and Outcomes in Immunocompetent and Immunocompromised Patients With Blastomycosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Blastomycosis Surveillance in 5 States, United States, 1987-2018.Emerging infectious diseases · 2021Review
- Endemic and Other Dimorphic Mycoses in The Americas.Journal of fungi (Basel, Switzerland) · 2021Review
- Review
- Blastomycosis in Minnesota, USA, 1999-2018.Emerging infectious diseases · 2020Article
- A case of disseminated blastomycosis with pulmonary, genitourinary, and osteoarticular involvement in southern Saskatchewan.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2020Article
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundBlastomycosis is a potentially life-threatening infection caused by the soil-based dimorphic fungus Blastomyces dermatitidis, which is endemic throughout much of the Midwestern United States. We investigated an increase in reported cases of blastomycosis that occurred during 2009-2010 in Marathon County, Wisconsin.
methodsCase detection was conducted using the Wisconsin Electronic Disease Surveillance System (WEDSS). WEDSS data were used to compare demographic, clinical, and exposure characteristics between outbreak-related and historical case patients, and to calculate blastomycosis incidence rates. Because initial mapping of outbreak case patients' homes and recreational sites demonstrated unusual neighborhood and household case clustering, we conducted a 1:3 matched case-control study to identify factors associated with being in a geographic cluster.
resultsAmong the 55 patients with outbreak-related cases, 33 (70%) were hospitalized, 2 (5%) died, 30 (55%) had cluster-related cases, and 20 (45%) were Hmong. The overall incidence increased significantly since 2005 (average 11% increase per year, P < .001), and incidence during 2005-2010 was significantly higher among Asians than non-Asians (2010 incidence: 168 vs 13 per 100 000 population). Thirty of the outbreak cases grouped into 5 residential clusters. Outdoor activities were not risk factors for blastomycosis among cluster case patients or when comparing outbreak cases to historical cases.
conclusionsThis outbreak of blastomycosis, the largest ever reported, was characterized by unique household and neighborhood clustering likely related to multifocal environmental sources. The reasons for the large number of Hmong affected are unclear, but may involve genetic predisposition.
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