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An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa.

Govender NP, Maphanga TG, Zulu TG, Patel J, Walaza S, Jacobs C, Ebonwu JI, Ntuli S, Naicker SD, Thomas J - PLoS Negl Trop Dis (2015)

Bottom Line: S. schenckii sensu stricto was identified as the causative pathogen.Sporotrichosis is a potentially re-emerging disease where traditional, rather than heavily mechanised, mining techniques are used.Surveillance should be instituted at sentinel locations.

View Article: PubMed Central - PubMed

Affiliation: National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa; University of the Witwatersrand, Johannesburg, South Africa.

ABSTRACT

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.

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Related in: MedlinePlus

Phylogenetic analysis of the partial calmodulin gene sequences from 10 clinical outbreak isolates, 5 environmental outbreak isolates, 9 unrelated clinical strains and 10 reference strains.
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pntd.0004096.g004: Phylogenetic analysis of the partial calmodulin gene sequences from 10 clinical outbreak isolates, 5 environmental outbreak isolates, 9 unrelated clinical strains and 10 reference strains.

Mentions: Thirty four partial calmodulin gene sequences were included in the alignment, 24 of which were generated in this study. The sequences of five environmental isolates (from 4 samples) clustered most closely with those of the S. mexicana type strain (Fig 4). The sequences of ten clinical isolates (from eight patients) clustered most closely with those of the S. schenckii sensu stricto type strain, the S. schenckii ATCC 6243 strain and the South African S. schenckii sensu stricto clinical isolates. The clinical strains were clearly separated from the S. brasilensis and S. globosa type strains.


An Outbreak of Lymphocutaneous Sporotrichosis among Mine-Workers in South Africa.

Govender NP, Maphanga TG, Zulu TG, Patel J, Walaza S, Jacobs C, Ebonwu JI, Ntuli S, Naicker SD, Thomas J - PLoS Negl Trop Dis (2015)

Phylogenetic analysis of the partial calmodulin gene sequences from 10 clinical outbreak isolates, 5 environmental outbreak isolates, 9 unrelated clinical strains and 10 reference strains.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4583532&req=5

pntd.0004096.g004: Phylogenetic analysis of the partial calmodulin gene sequences from 10 clinical outbreak isolates, 5 environmental outbreak isolates, 9 unrelated clinical strains and 10 reference strains.
Mentions: Thirty four partial calmodulin gene sequences were included in the alignment, 24 of which were generated in this study. The sequences of five environmental isolates (from 4 samples) clustered most closely with those of the S. mexicana type strain (Fig 4). The sequences of ten clinical isolates (from eight patients) clustered most closely with those of the S. schenckii sensu stricto type strain, the S. schenckii ATCC 6243 strain and the South African S. schenckii sensu stricto clinical isolates. The clinical strains were clearly separated from the S. brasilensis and S. globosa type strains.

Bottom Line: S. schenckii sensu stricto was identified as the causative pathogen.Sporotrichosis is a potentially re-emerging disease where traditional, rather than heavily mechanised, mining techniques are used.Surveillance should be instituted at sentinel locations.

View Article: PubMed Central - PubMed

Affiliation: National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa; University of the Witwatersrand, Johannesburg, South Africa.

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus