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An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa
BACKGROUND: The largest outbreak of sporotrichosis occurred between 1938 and 1947 in the gold mines of Witwatersrand in South Africa. Here, we describe an outbreak of lymphocutaneous sporotrichosis that was investigated in a South African gold mine in 2011. METHODOLOGY: Employees working at a reopen...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583532/ https://www.ncbi.nlm.nih.gov/pubmed/26407300 http://dx.doi.org/10.1371/journal.pntd.0004096 |
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author | Govender, Nelesh P. Maphanga, Tsidiso G. Zulu, Thokozile G. Patel, Jaymati Walaza, Sibongile Jacobs, Charlene Ebonwu, Joy I. Ntuli, Sindile Naicker, Serisha D. Thomas, Juno |
author_facet | Govender, Nelesh P. Maphanga, Tsidiso G. Zulu, Thokozile G. Patel, Jaymati Walaza, Sibongile Jacobs, Charlene Ebonwu, Joy I. Ntuli, Sindile Naicker, Serisha D. Thomas, Juno |
author_sort | Govender, Nelesh P. |
collection | PubMed |
description | BACKGROUND: The largest outbreak of sporotrichosis occurred between 1938 and 1947 in the gold mines of Witwatersrand in South Africa. Here, we describe an outbreak of lymphocutaneous sporotrichosis that was investigated in a South African gold mine in 2011. METHODOLOGY: Employees working at a reopened section of the mine were recruited for a descriptive cross-sectional study. Informed consent was sought for interview, clinical examination and medical record review. Specimens were collected from participants with active or partially-healed lymphocutaneous lesions. Environmental samples were collected from underground mine levels. Sporothrix isolates were identified by sequencing of the internal transcribed spacer region of the ribosomal gene and the nuclear calmodulin gene. PRINCIPAL FINDINGS: Of 87 male miners, 81 (93%) were interviewed and examined, of whom 29 (36%) had skin lesions; specimens were collected from 17 (59%). Sporotrichosis was laboratory-confirmed among 10 patients and seven had clinically-compatible lesions. Of 42 miners with known HIV status, 11 (26%) were HIV-infected. No cases of disseminated disease were detected. Participants with ≤3 years’ mining experience had a four times greater odds of developing sporotrichosis than those who had been employed for >3 years (adjusted OR 4.0, 95% CI 1.2–13.1). Isolates from 8 patients were identified as Sporothrix schenckii sensu stricto by calmodulin gene sequencing while environmental isolates were identified as Sporothrix mexicana. CONCLUSIONS/SIGNIFICANCE: S. schenckii sensu stricto was identified as the causative pathogen. Although genetically distinct species were isolated from clinical and environmental sources, it is likely that the source was contaminated soil and untreated wood underground. No cases occurred following recommendations to close sections of the mine, treat timber and encourage consistent use of personal protective equipment. Sporotrichosis is a potentially re-emerging disease where traditional, rather than heavily mechanised, mining techniques are used. Surveillance should be instituted at sentinel locations. |
format | Online Article Text |
id | pubmed-4583532 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-45835322015-10-02 An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa Govender, Nelesh P. Maphanga, Tsidiso G. Zulu, Thokozile G. Patel, Jaymati Walaza, Sibongile Jacobs, Charlene Ebonwu, Joy I. Ntuli, Sindile Naicker, Serisha D. Thomas, Juno PLoS Negl Trop Dis Research Article BACKGROUND: The largest outbreak of sporotrichosis occurred between 1938 and 1947 in the gold mines of Witwatersrand in South Africa. Here, we describe an outbreak of lymphocutaneous sporotrichosis that was investigated in a South African gold mine in 2011. METHODOLOGY: Employees working at a reopened section of the mine were recruited for a descriptive cross-sectional study. Informed consent was sought for interview, clinical examination and medical record review. Specimens were collected from participants with active or partially-healed lymphocutaneous lesions. Environmental samples were collected from underground mine levels. Sporothrix isolates were identified by sequencing of the internal transcribed spacer region of the ribosomal gene and the nuclear calmodulin gene. PRINCIPAL FINDINGS: Of 87 male miners, 81 (93%) were interviewed and examined, of whom 29 (36%) had skin lesions; specimens were collected from 17 (59%). Sporotrichosis was laboratory-confirmed among 10 patients and seven had clinically-compatible lesions. Of 42 miners with known HIV status, 11 (26%) were HIV-infected. No cases of disseminated disease were detected. Participants with ≤3 years’ mining experience had a four times greater odds of developing sporotrichosis than those who had been employed for >3 years (adjusted OR 4.0, 95% CI 1.2–13.1). Isolates from 8 patients were identified as Sporothrix schenckii sensu stricto by calmodulin gene sequencing while environmental isolates were identified as Sporothrix mexicana. CONCLUSIONS/SIGNIFICANCE: S. schenckii sensu stricto was identified as the causative pathogen. Although genetically distinct species were isolated from clinical and environmental sources, it is likely that the source was contaminated soil and untreated wood underground. No cases occurred following recommendations to close sections of the mine, treat timber and encourage consistent use of personal protective equipment. Sporotrichosis is a potentially re-emerging disease where traditional, rather than heavily mechanised, mining techniques are used. Surveillance should be instituted at sentinel locations. Public Library of Science 2015-09-25 /pmc/articles/PMC4583532/ /pubmed/26407300 http://dx.doi.org/10.1371/journal.pntd.0004096 Text en © 2015 Govender et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Govender, Nelesh P. Maphanga, Tsidiso G. Zulu, Thokozile G. Patel, Jaymati Walaza, Sibongile Jacobs, Charlene Ebonwu, Joy I. Ntuli, Sindile Naicker, Serisha D. Thomas, Juno An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa |
title | An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa |
title_full | An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa |
title_fullStr | An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa |
title_full_unstemmed | An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa |
title_short | An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa |
title_sort | outbreak of lymphocutaneous sporotrichosis among mine-workers in south africa |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583532/ https://www.ncbi.nlm.nih.gov/pubmed/26407300 http://dx.doi.org/10.1371/journal.pntd.0004096 |
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