Histoplasmosis 2003

Table 1. Histoplasmosis Cases by Race and Sex, Indiana, 2003

  2003 1999-2003
Cases Rate* Cases
Total 54 0.90 402
   White 34 0.60 271
   Black 5 0.90 54
   Other 0 0 3
   Not Reported 15 - 74
   Male 32 1.10 243
   Female 22 0.70 159
   Not Reported 0 - 0

*Rate per 100,000 population based on the U.S. Census Bureau’s population data as of July 1, 2003

Histoplasmosis is caused by Histoplasma capsulatum, a saprophytic soil fungus. The primary route of transmission is inhalation of infectious spores made airborne by the disturbance of contaminated soil. The presence of Histoplasma capsulatum has been associated with soil enriched with bird feces especially blackbirds, starlings, chickens, and pigeons. However, birds are not carriers of histoplasmosis, but accumulation of bird feces provide the organic enrichment needed for Histoplasma growth. Bat guano may also carry the organism.

Approximately 90 percent of Histoplasma capsulatum infections are asymptomatic. Clinically recognized histoplasmosis can be characterized into one of three forms:
1) acute, pulmonary histoplasmosis; 2) disseminated histoplasmosis; and 3) chronic, cavitary histoplasmosis. Symptoms of acute cases are flu-like with nonproductive cough, chest pains, and difficult breathing. More severe disease may result in fever, night sweats, weight loss, and bloody sputum. Severe cases may result in Histoplasma organisms being disseminated to many body organs.

In 2003, 54 confirmed cases of histoplasmosis were reported in Indiana for a crude incidence rate of less than one person per 100,000 population (Table 1). Figure 1 illustrates the number of cases by year for 1999-2003. Histoplasmosis occurred throughout the year in 2003 with the largest number of cases in the winter (Figure 2). Figure 3 displays the distribution of cases by age group. Age-specific rates were greatest among adults aged 30-69 years of age. Males (1.1) were slightly more likely to be reported with histoplasmosis infection than females (0.7).

The only county reporting five or more cases in 2003 was Marion County, which had an incidence rate of less than 1 case per 100,000 population.

You can learn more about histoplasmosis by visiting the following Web site:
CDC Website:  Histoplasmosis