Multistate epidemiology of histoplasmosis, united states, 2011–2014

Paige A. Armstrong, Brendan R. Jackson, Dirk Haselow, Virgie Fields, Malia Ireland, Connie Austin, Kimberly Signs, Veronica Fialkowski, Reema Patel, Peggy Ellis, Peter C. Iwen, Caitlin Pedati, Suzanne Gibbons-Burgener, Jannifer Anderson, Thomas Dobbs, Sherri Davidson, Mary McIntyre, Kimberly Warren, Joanne Midla, Nhiem LuongKaitlin Benedict

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Histoplasmosis is one of the most common mycoses endemic to the United States, but it was reportable in only 10 states during 2016, when a national case definition was approved. To better characterize the epidemiologic features of histoplasmosis, we analyzed deidentified surveillance data for 2011–2014 from the following 12 states: Alabama, Arkansas, Delaware, Illinois, Indiana, Kentucky, Michigan, Minnesota, Mississippi, Nebraska, Pennsylvania, and Wisconsin. We examined epidemiologic and laboratory features and calculated state-spe-cific annual and county-specific mean annual incidence rates. A total of 3,409 cases were reported. Median patient age was 49 (interquartile range 33–61) years, 2,079 (61%) patients were male, 1,273 (57%) patients were hospitalized, and 76 (7%) patients died. Incidence rates varied markedly between and within states. The high hospitalization rate suggests that histoplasmosis surveillance underestimates the true number of cases. Improved surveillance standardization and surveillance by additional states would provide more comprehensive knowledge of histoplasmosis in the United States.

Original languageEnglish (US)
Pages (from-to)425-431
Number of pages7
JournalEmerging infectious diseases
Issue number3
StatePublished - Mar 2018

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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