An Epidemic of Histoplasmosis in a Family

SUMMARY An "epidemic" of histoplasmosis results when several persons become ill from generalization of a pulmonary infection incurred by simultaneous inhalation of dust containing the organism Histoplasma capsulatum. A number of such epidemics have been reported, involving almost 400 persons. For the most part these have occurred in the endemic area of central United States. The authors report an epidemic in a family from northern Virginia consisting of young parents and four children, five to 11 years of age, who were exposed at the same time to the dust raised during the cleaning of a chicken house. In 10 to 12 days they became variably ill with fever, malaise, non-productive cough, irritability, weakness, nausea, anorexia, and headache. Roentgenograms of the chest showed pathology in all proportional to the degree of exposure and comparable to the severity of the symptoms. The only significant physical abnormalities were mild generalized adenopathy in the children and palpable liver in the father. The skin tests and complement fixation tests were positive in all six members of the family. Cultures of blood and marrow in the mother and children were negative for H. capsulatum, but this organism was ultimately recovered on culture from a specimen of the guano from the floor of the chicken house. The illness lasted about six weeks. The roentgenograms showed a tendency to improvement, but the family, who are migrants, have not been heard from for some months.