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Microsporidiosis is a disease caused by infection with microscopic organisms called microsporidia. Microsporidia are eukaryotic parasites that must live within other host cells in which they can produce infective spores. Microsporidiosis can cause infection of the intestine, lung, kidney, brain, sinuses, muscles, and eyes.
Intestinal symptoms that are caused by microsporidia infection include chronic diarrhea, wasting, malabsorption, and gallbladder disease. Symptoms of microsporidiosis primarily occur in people with immune-system deficiency, such as HIV-infected individuals and organ-transplant recipients.
Lung symptoms may include cough and difficult, labored breathing.
Transmission
Microsporidia spores are released from the stool and urine of infected animals. A number of animals, including insects, birds, and mammals, can serve as reservoirs of infection for microsporidia. These spores are then consumed or inhaled by humans.
Histoplasmosis is a type of lung infection. It is caused by inhaling Histoplasma capsulatum fungal spores. These spores are found in soil and in the droppings of bats and birds. This fungus mainly grows in the central, southeastern, and mid-Atlantic states.
Most cases of histoplasmosis don’t require treatment. However, people with weaker immune systems may experience serious problems. The disease may progress and spread to other areas of the body. Skin lesions have been reported in 10 to 15 percent of cases of histoplasmosis that has spread throughout the body. What Should I Watch For?
Most people who are infected with this fungus have no symptoms. However, the risk of symptoms increases as you breathe in more spores. If you are going to have symptoms, they generally show up about 10 days after exposure.
Possible symptoms include:
fever
dry cough
chest pain
joint pain
red bumps on your lower legs
In severe cases, symptoms may include:
excessive sweating
shortness of breath
coughing up blood
Widespread histoplasmosis causes inflammation and irritation. Symptoms may include:
chest pain, caused by swelling around the heart
high fever
stiff neck and headaches, from swelling around the brain and spinal cord
Blastomycosis is an infection caused by a fungus called Blastomyces. The fungus lives in the environment, particularly in moist soil and in decomposing matter such as wood and leaves. Blastomyces mainly lives in areas of the United States and Canada surrounding the Ohio and Mississippi River valleys and the Great Lakes. People can get blastomycosis after breathing in the microscopic fungal spores from the air. Although most people who breathe in the spores don’t get sick, some of those who do may have flu-like symptoms, and the infection can sometimes become serious if it is not treated.
Blastomycosis is a caused by the fungusBlastomyces dermatitidis. The fungus lives in moist soil and is associated with decomposing organic matter. Some individuals can have lung infections after inhaling airborne fungal spores although many do not become ill. The symptoms of blastomycosis are similar to those of influenza.
Blastomyces in generally found in the midwestern, south-central, and southeastern states.
There has not been a case of Blastomycosis reported in Arizona in the past 10 years.
Transmission
Transmission occurs through inhalation of the Blastomyces dermatitidis spores from the environment.
Incubation period may be weeks to months. In symptomatic patients the median incubation period is 45 days.
Lab Tests & Specimen Info
Test*
Specimen
Culture (the specimens are in order of usefulness)
Serum, CSF (Test can measure prior exposure to the fungus)
Isolation Precautions
Blastomycosis is not a communicable disease.
Standard precautions are recommended in healthcare settings.
Prevention for Patients Anyone can become infected with the Blastomyces dermatitidis spores but individuals with underlying medical conditions may be at increased risk for infection. Individuals with weakened immune systems may consider avoiding wooded areas where they might come in contact with the fungus.
Sporotrichosis is a fungal infection caused by Sporothrix schenckii. Cutaneous infections are the most common form of infection but pulmonary infections can occur. The symptoms of a cutaneous infection can include a small painless nodule that may appear on the fingers, hands, or arms where the fungus entered the body. The nodule may become larger and look like an open sore or ulcer. Infections may become disseminated to other parts of the body include bones, joints, and CNS but this usually only occurs in individuals with weakened immune systems.
The fungus lives in sphagnum moss, hay or other plant materieral.
Transmission
Transmission occurs when the fungus enters the skin through a cut or puncture in the skin.
Sporotrichosis is not spread person to person.
Incubation period is 7 to 30 days.
Lab Tests & Specimen Info
Test*
Specimen
Culture
Drainage (pus), Abscess Drainage, Skin Biopsy
Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
Wearing protective clothing such as gloves and long sleeves when handing wires, rose bushes, bales of hay, pine seedlings or other material that may cause minor cuts
Kawasaki disease is an acute febrile illness primarily affecting children 5 years of age or younger. The most common symptoms are: fever, rash, swelling of the hands and feet, desquamation of the hands and feet, and irritation and inflammation of the tongue and mouth. Approximately 20% of children who do not get treatment develop coronary artery abnormalities, including aneurysms.
Arizona 5 year median: 20 cases
Transmission
Unknown, but there is no evidence of common source or person-to-person transmission.
Lab Tests & Specimen Info
No tests available.
Isolation Precautions
Standard precautions are recommended in healthcare settings.
St. Louis encephalitis is a viral disease caused by St. Louis encephalitis virus (SLEV). Most individuals that are infected will have no signs of illness. Symptoms can include:
fever
headache
nausea
vomiting
tiredness
Some individual may go on to have a severe neuroinvasive disease which will most commonly include encephalitis. This severe disease occurs most commonly in older adults.
St. Louis encephalitis virus is endemic in Arizona.
Transmission
Transmission occurs when an individual is bitten by an infected mosquito.
Incubation period is 5 to 15 days.
Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
The best way to prevent infection is to avoid being bitten by mosquitoes. Methods include:
Wearing long pants and long-sleeved shirts
Using insect repellent
Using screens in windows or doors
Public Health Actions
Public health will conduct an epidemiological investigation on a case or suspect case.
Varicella (chickenpox) is a viral infection that is caused by varicella-zoster virus. Symptoms generally appear 10 to 21 days after exposure to the virus and can include:
high fever
loss of appetite
headache
generalized and pruritic rash
The rash will progress from macules to papules to vesicular lesions before crusting. It will usually take 1 week for the lesions to crust over.
Some individuals in high risk groups can go on to have more severe symptoms such as:
pneumonia
bleeding problems
encephalitis
sepsis
Those high risk groups include infants, pregnant women, and individuals with weakened immune systems.
Individuals are contagious 2 days before blisters appear until all blisters have completed scabbed over.
Over the last 5 years between 300 and 600 cases of varicella are reported in Arizona each year.
Arizona 5 year median: 300 cases
Transmission
Transmission occurs when the virus is spread through the air by the cough or sneezes of an infected individual. Transmission can also occur by touching or breathing in the virus that can come from the blisters.
Incubation period is 10 to 21 days (average of 14 to 16 days).
Impression smears of tissues, Lesion scrapings and swabs
IgG/IgM Serology
Serum
Public Health Actions
Individuals should be excluded from school/child care until all blisters are scabbed over and dry and the individual is fever-free for 24 hours without the use of fever-reducing medications.
Public health will complete an epidemiological investigation for reports of death due to varicella infection.
Yellow fever is an infection caused by the Yellow fever virus. The majority of individuals will have no illness or a mild illness. Symptoms include:
fever
chills
headache
body aches
nausea
vomiting
fatigue
weakness
Approximately 15% of cases will go on to develop a more severe disease which can include high fever, jaundice, bleeding, and eventually shock and multiorgan failure.
Yellow fever virus is generally found in tropical and subtropical areas of South America and Africa.
Arizona has not had a case of yellow fever reported in the last 10 years.
Transmission
Transmission occurs when an individual is bitten by an infected mosquito. It is not transmitted person-to-person. Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
Vaccination against Yellow fever is the best prevention method for individuals. Avoiding contact with mosquitoes is also another prevention method. Methods include:
Wearing long pants and long-sleeved shirts
Using insect repellent
Using screens in windows or doors
Public Health Actions
Individuals should be advised to avoid further mosquito exposure during the first 5 days after fever onset to help reduce the transmission of the virus to more mosquitos.
Public health will conduct an epidemiological investigation on a case or suspect case.
Lassa fever is an acute viral illness that occurs in west Africa.
For the majority of Lassa fever virus infections, symptoms are mild and are undiagnosed. However, disease may progress to more serious symptoms including:
hemorrhaging (in gums, eyes, or nose, as examples)
respiratory distress
repeated vomiting
facial swelling
pain in the chest, back, and abdomen
shock
Neurological problems have also been described, including hearing loss, tremors, and encephalitis.
Transmission
The reservoir, or host, of Lassa virus is a rodent known as the "multimammate rat". Transmission of Lassa virus to humans occurs most commonly through ingestion or inhalation. Mastomys rodents shed the virus in urine and droppings and direct contact with these materials, through touching soiled objects, eating contaminated food, or exposure to open cuts or sores, can lead to infection.
Contact with the virus may also occur when a person inhales tiny particles in the air contaminated with infected rodent excretions. This aerosol or airborne transmission may occur during cleaning activities, such as sweeping.
Person-to-person transmission may occur after exposure to virus in the blood, tissue, secretions, or excretions of a Lassa virus-infected individual.
Incubation period can range from 1-3 weeks. Isolation Precautions
Standard, droplet, and contact precautions are recommended in healthcare settings.
Single-patient rooms are also preferred.
Prevention for Patients
Primary transmission of the Lassa virus from its host to humans can be prevented by avoiding contact with Mastomys rodents, especially in the geographic regions where outbreaks occur.
Putting food away in rodent-proof containers and keeping the home clean help to discourage rodents from entering homes
Using these rodents as a food source is not recommended
Trapping in and around homes can help reduce rodent populations (however, the wide distribution of Mastomys in Africa makes complete control of this rodent reservoir impractical)
