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A large outbreak of histoplasmosis among American travelers associated with a hotel in Acapulco, Mexico, spring 2001.
Am J Trop Med Hyg. 2003 Dec; 69(6):663-9.AJ

Abstract

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.

Authors+Show Affiliations

Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. JMorgan1@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14740886

Citation

Morgan, Juliette, et al. "A Large Outbreak of Histoplasmosis Among American Travelers Associated With a Hotel in Acapulco, Mexico, Spring 2001." The American Journal of Tropical Medicine and Hygiene, vol. 69, no. 6, 2003, pp. 663-9.
Morgan J, Cano MV, Feikin DR, et al. A large outbreak of histoplasmosis among American travelers associated with a hotel in Acapulco, Mexico, spring 2001. Am J Trop Med Hyg. 2003;69(6):663-9.
Morgan, J., Cano, M. V., Feikin, D. R., Phelan, M., Monroy, O. V., Morales, P. K., Carpenter, J., Weltman, A., Spitzer, P. G., Liu, H. H., Mirza, S. A., Bronstein, D. E., Morgan, D. J., Kirkman, L. A., Brandt, M. E., Iqbal, N., Lindsley, M. D., Warnock, D. W., & Hajjeh, R. A. (2003). A large outbreak of histoplasmosis among American travelers associated with a hotel in Acapulco, Mexico, spring 2001. The American Journal of Tropical Medicine and Hygiene, 69(6), 663-9.
Morgan J, et al. A Large Outbreak of Histoplasmosis Among American Travelers Associated With a Hotel in Acapulco, Mexico, Spring 2001. Am J Trop Med Hyg. 2003;69(6):663-9. PubMed PMID: 14740886.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A large outbreak of histoplasmosis among American travelers associated with a hotel in Acapulco, Mexico, spring 2001. AU - Morgan,Juliette, AU - Cano,Maria V, AU - Feikin,Daniel R, AU - Phelan,Maureen, AU - Monroy,Oscar Velazquez, AU - Morales,Pablo Kuri, AU - Carpenter,Joseph, AU - Weltman,Andre, AU - Spitzer,Peter G, AU - Liu,Hans H, AU - Mirza,Sara A, AU - Bronstein,David E, AU - Morgan,Daniel J, AU - Kirkman,Laura A, AU - Brandt,Mary E, AU - Iqbal,Naureen, AU - Lindsley,Mark D, AU - Warnock,David W, AU - Hajjeh,Rana A, AU - ,, PY - 2004/1/27/pubmed PY - 2004/2/10/medline PY - 2004/1/27/entrez SP - 663 EP - 9 JF - The American journal of tropical medicine and hygiene JO - Am. J. Trop. Med. Hyg. VL - 69 IS - 6 N2 - 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. SN - 0002-9637 UR - https://www.unboundmedicine.com/medline/citation/14740886/full_citation L2 - http://www.ajtmh.org/cgi/pmidlookup?view=long&amp;pmid=14740886 DB - PRIME DP - Unbound Medicine ER -