Evidence map›Paper›PMID 40928323›Full record

ArticleThe Journal of infectious diseases2025

Updating the Epidemiology of Blastomycosis and Histoplasmosis in the United States, Using National Electronic Health Record Data, 2013-2023.

Juliana G E Bartels, Simon K Camponuri, Theo T Snow, Brittany L Morgan Bustamante, Natalie J Kane, Rose M Reynolds, Aidan Lee, Mark A Hoffman, Theodore C White, Justin V Remais and 1 more

Abstract read
In one paragraph

Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Juliana G E BartelsDivision of Environmental Health Sciences, University of California, Berkeley, California, USA.ORCID 0009-0006-0734-0667
Simon K CamponuriDivision of Environmental Health Sciences, University of California, Berkeley, California, USA.ORCID 0000-0003-3787-170X
Theo T SnowDivision of Environmental Health Sciences, University of California, Berkeley, California, USA.
Brittany L Morgan BustamanteDivision of Environmental Health Sciences, University of California, Berkeley, California, USA.ORCID 0000-0002-0280-0904
Natalie J KaneChildren's Mercy Research Institute, Kansas City, Missouri, USA.ORCID 0000-0003-0204-339X
Rose M ReynoldsChildren's Mercy Research Institute, Kansas City, Missouri, USA.ORCID 0000-0002-3154-6802
Aidan LeeSchool of Letters and Sciences, University of California, Berkeley, Berkeley, California, USA.ORCID 0009-0005-1797-9766
Mark A HoffmanChildren's Mercy Research Institute, Kansas City, Missouri, USA.ORCID 0000-0003-3140-6524
Theodore C WhiteSchool of Science and Engineering, University of Missouri-Kansas City, Kansas City, Missouri, USA.ORCID 0000-0003-3229-1378
Justin V RemaisDivision of Environmental Health Sciences, University of California, Berkeley, California, USA.ORCID 0000-0002-0223-4615
Jennifer R HeadDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0003-1449-4171

Funding

Integrating Epidemiologic and Environmental Approaches to Understand and Predict Coccidioides Exposure and Coccidioidomycosis EmergenceR01AI148336 · NIAID · UNIVERSITY OF CALIFORNIA BERKELEY · PI REMAIS, JUSTIN V · 2020 to 2024
$4.5M
Using massive, multi-regional EHR data to estimate the impacts of environmental and other risk factors on fungal disease epidemiology in the U.S.R01AI176770 · NIAID · UNIVERSITY OF MISSOURI KANSAS CITY · PI Mark Hoffman, Justin V Remais · 2023 to 2026
$3.2M
Modelled estimation of population immunity for coccidioidomycosis and the role of immunologically naïve populations in the shifting epidemiology of coccidioidomycosis in CaliforniaK01AI173529 · NIAID · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jennifer Head · 2023 to 2026
$478k
Advancing Fungal Disease Epidemiology through Multilevel Modeling and Data IntegrationK01AI190048 · NIAID · UNIVERSITY OF CALIFORNIA-IRVINE · PI Brittany Lauren Morgan Bustamante · 2025 to 2026
$396k
CDC HHS T42 OH008429National InstituteNational Institute of Allergy and Infectious DiseasesNIAID NIH HHS K01 AI173529NIAID NIH HHS K01 AI190048NIAID NIH HHS R01 AI148336NIAID NIH HHS R01 AI176770NIH HHS K01 AI173529NIH HHS R01 AI148336NIH HHS R01 AI176770NIOSH CDC HHS T42 OH008429
6 · The paper itself

Abstract

backgroundWhere surveillance data are limited, nationally representative electronic health records allow for geographic, temporal, and demographic characterization of the fungal diseases blastomycosis and histoplasmosis.

methodsWe identified incident blastomycosis and histoplasmosis cases from 2013 to 2023 within Oracle EHR Real-World Data, which comprises 1.6 billion healthcare encounters nationally. To characterize spatiotemporal incidence trends, we used generalized estimating equations weighted for nonrepresentativeness of electronic health record-reporting facilities. We computed standardized incidence rate ratios (sIRRs), which relay relative differences in standardized incidence rates between regions, race/ethnicity, gender, and age subgroups and the national population.

resultsNational incidence rates in 2023 were 2.4 (95% confidence interval [CI]: 1.6-3.5) and 1.9 times (95% CI: 1.6-2.2) rates in 2013, for blastomycosis and histoplasmosis, respectively. Blastomycosis incidence rates among Hispanic or Latino and non-Hispanic Black individuals were 60% (sIRR: 1.6 [95% CI: 1.0-2.4]) and 30% (sIRR: 1.3 [95% CI: 1.0-1.6]) higher than the standardized national incidence rate. Histoplasmosis incidence rates were elevated among non-Hispanic White patients (sIRR: 1.05 [95% CI: 1.02-1.08]). Standardized incidence rates of both diseases were higher among older and male patients, were consistently elevated in the Upper Midwest and Ohio Valley regions, and increased greatly in the Northern Rockies and Plains from 2013 to 2023. We estimated high incidence in states (blastomycosis: Illinois, Kentucky, and West Virginia; histoplasmosis: Missouri, Iowa, and Oklahoma) that do not report to surveillance.

conclusionsThis analysis revealed increasing incidence rates of blastomycosis and histoplasmosis, with increasing diagnoses outside of historically endemic regions, and notable differences in incidence by race/ethnicity, gender, and age.

Indexed as

BlastomycosisElectronic Health RecordsHistoplasmosisAdolescentAdultAgedAged, 80 and overChildChild, PreschoolFemaleHumansIncidenceInfantInfant, NewbornMaleMiddle Agedblastomycosisdisease emergenceelectronic health recordsendemic mycoseshistoplasmosis

Identifiers

PMID40928323
PMCPMC12718065

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.