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Background
Cryptococcus gattii is an
environmental fungus that has been isolated from trees,
soil, air, and water. Since 1999, C. gattii has
been known to occur on Vancouver Island, British Columbia,
Canada, and has caused disease among residents, visitors to
the island, and domestic and wild animals. The fungus has
since spread to mainland British Columbia and Washington
State. Unlike the closely related species C. neoformans,
an opportunistic pathogen of immunocompromised hosts with
other medical conditions, C. gattii also
affects immunocompetent persons who were previously
healthy. The infection is caused by breathing in the spores
of the Cryptococcus fungus. It is not transmitted
from person-to-person or from animal-to-person.
Reported symptoms include severe
cough and shortness of breath. There may be other
symptoms such as chills, night sweats, and loss of appetite.
About a fifth of cases have meningitis. Smoking or
treatment with steroids may be risk factors for infection.
The incubation period appears to be 2 to 12 months.
Since both C. gattii and C. neoformans cause
similar illnesses, special testing is needed to
differentiate between C. gattii and C. neoformans.
Positive cryptococcal cultures should be sent to the Public
Health Laboratories for further testing.
Cryptococcus gattii in
Washington State
During 2005 three cats living in Washington near
the Canadian border were diagnosed with C. gattii by
histopathology. None of the animals had exposures in
Canada. In 2006, the organism was recovered by researchers
from University of British Columbia from soil samples in
Whatcom County, Washington. In addition, two Washington
State residents with cryptococcal disease may have been
locally exposed in 2006. Both patients traveled during
their exposure period, so out-of-state acquisition could not
be ruled out. During 2007, six human cases were reported.
Four of the 2007 cases did not travel out of state during
their exposure period, indicating in-state acquisition.
Purpose of Reporting and
Surveillance
- To detect the emergence of Cryptococcus gattii in
Washington
- To improve the number of suspected cases that are
laboratory confirmed
- To monitor trends in the epidemiology of Cryptococcal
disease
Legal Reporting Requirements
Human or animal infections with C. gattii are
reportable in Washington State as rare diseases of public
health significance.
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Healthcare providers:
immediately notifiable to Local Health Jurisdiction
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Hospitals: immediately
notifiable to Local Health Jurisdiction
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Laboratories: no requirements
for reporting
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Local health jurisdictions:
immediately notifiable to DOH Communicable Disease
Epidemiology: 1-877-539-4344
Last
update
March 2008 |
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