SECTION I - INFECTIOUS AGENT


NAME: Histoplasma capsulatum


SYNONYM OR CROSS REFERENCE:
Histoplasmosis


CHARACTERISTICS: Dimorphic fungus, mold form in soil, yeast form in animals and human hosts.

SECTION II - HEALTH HAZARD

PATHOGENICITY: Systematic mycosis of varying severity with primary lesion in lungs; five clinical forms - asymptomatic, acute benign respiratory, acute disseminated, chronic disseminated, chronic pulmonary; some forms can be fatal.

EPIDEMIOLOGY: Focal infections are common worldwide; clinical disease and severe progressive disease less frequent; 80% of population show hypersensitivity to H. capsulatum in eastern and central North America; outbreaks in families or groups exposed to bird or bat droppings or recently disturbed contaminated soil.


HOST RANGE: Humans, dogs, cats, rats, skunks, foxes and other animals.


INFECTIOUS DOSE: 10 spores lethal inoculum in mice.


MODE OF TRANSMISSION: Inhalation of airborne conidia; small size of infective conidia (<5 mm) is conducive to airborne dispersal and intrapulmonary retention.


INCUBATION PERIOD: Symptoms appear within 5-18 days after exposure, commonly 10 days.


COMMUNICABILITY: Not transmitted from person to person.

SECTION III - DISSEMINATION

RESERVOIR: Soil (around old chicken houses), caves harboring bats, and around starling roosts- around older houses sheltering the common brown bat; other soils with high organic content and in decaying trees.


ZOONOSIS: Yes, although not direct zoonosis, however, organism grows particularly well in soil contaminated with fecal material of birds or bats.


VECTORS: None

SECTION IV - VIABILITY

DRUG SUSCEPTIBILITY: Sensitive to amphotericin B, ketoconazole, itraconazole.


SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite (20% commercial bleach), phenolics, glutaraldehyde, formaldehyde; susceptibility to 70% ethanol questionable.


PHYSICAL INACTIVATION: Inactivated by moist heat (121o C for at least 15 min.).


SURVIVAL OUTSIDE HOST: Spores are resistant to drying and may remain viable for long periods of time.

SECTION V - MEDICAL

SURVEILLANCE: Monitor for symptoms; confirm by culture, microscopic examination of specimens, and serologic response.


FIRST AID/TREATMENT: Amphotericin B for disseminated or chronic pulmonary cases; conazole drugs may be added or used in rotation for therapy in immunocompromised patients because relapse is common.


IMMUNIZATION: None


PROPHYLAXIS: None

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: Documented hazard in labs conducting diagnostic or investigative work; 71 reported cases with I death - pulmonary infection from handling mold from cultures, local infection from skin puncture during autopsy, accidental needle inoculation of viable culture.


SOURCES/SPECIMENS: Infective stage (conidia) present in sporulating mold from cultures and in soil from endemic areas; yeast form in tissues or fluids from infected animals (may produce local infection following parental inoculation).


PRIMARY HAZARDS: Inhalation of infective conidia, contact with broken skin or mucus membranes, accidental parenteral inoculation.


SPECIAL HAZARDS: Collecting and processing soil samples from endemic areas has caused pulmonary infections in lab workers.

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: Biosafety level 3 practices, containment equipment and facilities for processing mold cultures, soil, or other material known or likely to contain infectious conidia.


PROTECTIVE CLOTHING: Lab coat; gloves and gown with tight wrists and ties in back when working with agent.


OTHER PRECAUTIONS: Appropriate precautions and practices to minimize the production of infectious aerosols.

SECTION VIII - HANDLING INFORMATION

SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with paper towels and apply 1% sodium hypochlorite (20% commercial bleach), starting at perimeter and working towards the center; allow sufficient contact time (30 min) before clean up.


DISPOSAL:
Decontaminate before disposal; steam sterilization, incineration, chemical disinfection.


STORAGE: In sealed containers that are appropriately labeled.


Date prepared.- October 11, 1997 Prepared by: Canadian Office of Biosafety Information edited by the Colorado State University Office of Biosafety; June 16, 1998.

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