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Mycopathologia

, Volume 161, Issue 5, pp 275–282 | Cite as

Geographic Distribution of Human Blastomycosis Cases in Milwaukee, Wisconsin, USA: Association with Urban Watersheds

  • Dennis J. BaumgardnerEmail author
  • Erica M. Knavel
  • Dale Steber
  • Geoffrey R. Swain
Article

Abstract

Most studies of endemic blastomycosis and outbreaks have involved rural areas. Case homesites in rural Northern Wisconsin have been associated with waterways and sand soils. ARC-GIS was used to geocode addresses and to observe geographic features of homesites from 45 State-mandated reports of human blastomycosis in urban Milwaukee County, Southeastern Wisconsin 2000–2004. Each case property was directly observed, and houses and duplexes (N = 38) were compared with 151 same-street control homesites. Categorical data was analyzed using a chi-square or Fisher’s exact test; continuous variables by Kruskal–Wallis test. One case cluster was seen on Milwaukee’s North side where the estimated annual incidence was 2.8/100,000 compared to 0.96/100,000 for the entire county. Cases were less common in the most urbanized watersheds (0.49/100,000/yr) versus Lake Michigan shores (0.85) versus remaining three open watersheds (1.4) [P<0.01]. Case homesites averaged 1067 m to waterways and none were on sand soils. (Comparison is made to a Northern Wisconsin community where case homesites averaged 354 m to waterways, 24/25 were on sand soils and annual incidence was 74/100,000.) No unique features of case homesites were identified in Milwaukee County. In this urban area of Wisconsin, relatively low incidence rates may be explained, in part, by lower density of inland waterways and lack of sand soils, however, blastomycosis cases appear to be associated with open watersheds.

Keywords

Blastomyces dermatitidis blastomycosis geographic information systems lung infections mycoses 

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References

  1. 1.
    Restrepo, A, Baumgardner, DJ, Bagagli, E,  et al. 2000Clues to the presence of pathogenic fungi in certain environmentsMed. Mycol.386777PubMedGoogle Scholar
  2. 2.
    DiSalvo, AF 1992The ecology of B. dermatitidisAl-Doory, YDiSalvo, AF eds. BlastomycosisPlenumNew York4373Google Scholar
  3. 3.
    DiSalvo, AF 1992The epidemiology of blastomycosisAl-Doory, YDiSalvo, AF eds. BlastomycosisPlenumNew York75104Google Scholar
  4. 4.
    Klein, BS, Vergeront, JM, Weeks, RJ,  et al. 1986Isolation of Blastomyces dermatitidis in soil associated with a large outbreak of blastomycosis in WisconsinNew. Engl. J. Med.314529534PubMedCrossRefGoogle Scholar
  5. 5.
    Baumgardner, DJ, Buggy, BP, Mattson, BJ, Burdick, JS, Ludwig, D 1992Epidemiology of blastomycosis in a region of high endemicity in north central WisconsinClin. Infect. Dis.15629635PubMedGoogle Scholar
  6. 6.
    Baumgardner, DJ, Paretsky, DP, Yopp, AC 1995The epidemiology of blastomycosis in dogs: North central Wisconsin, USAJ. Med. Vet. Mycol.33171176PubMedGoogle Scholar
  7. 7.
    Baumgardner, DJ, Paretsky, DP 1999The in vitro isolation Blastomyces dermatitidis from a woodpile in north central Wisconsin, USAMed. Mycol.37163168CrossRefPubMedGoogle Scholar
  8. 8.
    Baumgardner, DJ, Brockman, K 1998Epidemiology of human blastomycosis in Vilas County,Wisconsin II: 1991–1996Wis. Med. J.974447Google Scholar
  9. 9.
    Baumgardner, DJ, Steber, D, Glazier, R, Paretsky, DP, Egan, G, Baumgardner, AM, Prigge, D 2005Geographic information system analysis of blastomycosis in northern Wisconsin USA: Waterways and soilMed. Mycol.43117125CrossRefPubMedGoogle Scholar
  10. 10.
    Vasquez, JE, Meha, JB, Agrawal, R, Sarubbi, FA 1998Blastomycosis in northeast TennesseeChest114436443PubMedGoogle Scholar
  11. 11.
    Dwight, PJ, Nau, M, Sarfield, P, Limerick, B 2000An outbreak of human blastomycosis: The epidemiology of blastomycosis in the Kenora catchment region of Ontario, CanadaCan. Commun. Dis. Rep.268291PubMedGoogle Scholar
  12. 12.
    Cano, MV, Ponce-de-Leon, GF, Tippen, S, Lindsley, MD, Warwick, M, Hajjeh, RA 2003Blastomycosis in Missouri: Epidemiology and risk factors for endemic diseaseEpidemiol. Infect.131907914CrossRefPubMedGoogle Scholar
  13. 13.
    Proctor, ME, Klein, BS, Jones, JM, Davis, JP 2002Cluster of pulmonary blastomycosis in a rural community: Evidence for multiple high-risk environmental foci following a sustained period of diminished precipitationMycopathologia153113120CrossRefPubMedGoogle Scholar
  14. 14.
    Baumgardner, DJ, Paretsky, DP 2001Blastomycosis: More evidence for exposure near one’s domicileWis. Med. J.1004345Google Scholar
  15. 15.
    Lowry, PW, Kelso, KY, McFarland, LM 1989Blastomycosis in Washington Parish, Louisiana, 1976–1985Am. J. Epidemiol.130151159PubMedGoogle Scholar
  16. 16.
    Arceneaux, KA, Taboada, J, Hosgood, G 1998Blastomycosis in dogs: 115 cases (1980–1995)J. Am. Vet. Med. Assoc.213658664PubMedGoogle Scholar
  17. 17.
    Chapman, SW, Lin, AC, Hendricks, KA,  et al. 1997Endemic blastomycosis in Mississippi: Epidemiological and clinic studiesSemin. Respir. Infect.12219228PubMedGoogle Scholar
  18. 18.
    Kitchen, MS, Reiber, CD, Eastin, GB 1977An urban epidemic of North American blastomycosisAm. Rev. Respir. Dis.11510631066PubMedGoogle Scholar
  19. 19.
    Lee, D, Eapren, S, VanBuren, J, Jones, P, Baumgardner, DJ 2006A young man who could not walkWis. Med. J.1055861Google Scholar
  20. 20.
    Walker, L 1981American ShelterOverlook PressWoodstock NYGoogle Scholar
  21. 21.
    Kurta, A 1995Mammals of the Great Lakes Region, rev. edUniversity of Michigan PressAnn ArborGoogle Scholar
  22. 22.
    Baumgardner, DJ, Summerbell, R, Krajden, S, Alexopoulous, I, Agrawal, B, Bergeson, M,  et al. 2005Attempted isolation of Blastomyces dermatitidis from native shrews in northern Wisconsin, USAMed. Mycol.43413416CrossRefPubMedGoogle Scholar
  23. 23.
    Roussere, GP, Murray, WJ, Raudenbush, CB, Kutilek, MJ, Levee, DJ, Kazacos, KR 2003Raccoon roundworm eggs near homes and risk for larva migrans disease, California communitiesEmerg. Infect. Dis.915161522PubMedGoogle Scholar
  24. 24.
    Manetti, AC 1991Hyperendemic urban blastomycosisAm. J. Public Health81633636PubMedCrossRefGoogle Scholar
  25. 25.
    Dott, RH,Jr, Attig, JW 2004Roadside Geology of WisconsinMountain PressMissoula MTGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Dennis J. Baumgardner
    • 1
    • 2
    • 5
    Email author
  • Erica M. Knavel
    • 1
  • Dale Steber
    • 3
  • Geoffrey R. Swain
    • 1
    • 3
    • 4
  1. 1.Department of Family MedicineUniversity of Wisconsin Medical SchoolMilwaukeeUSA
  2. 2.Center for Urban Population Health, and Aurora Health CareMilwaukeeUSA
  3. 3.Center for Urban Population HealthMilwaukeeUSA
  4. 4.City of Milwaukee Health DepartmentMilwaukeeUSA
  5. 5.Department of Family MedicineUW/AuroraMilwaukeeUSA

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