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. 2011 Jun;13(3):256-61.
doi: 10.1007/s11908-011-0181-0.

The Outbreak of Cryptococcus gattii in Western North America: Epidemiology and Clinical Issues

Edmond J Byrnes 3rd  1 , Kieren A Marr
Affiliations

The Outbreak of Cryptococcus gattii in Western North America: Epidemiology and Clinical Issues

Edmond J Byrnes 3rd et al. Curr Infect Dis Rep. 2011 Jun.

Abstract

Over the previous decade, we observed the emergence of the fungal pathogen, Cryptococcus gattii, as a cause of disease in humans and animals in a temperate climate. This outbreak, first documented on Vancouver Island, has since expanded throughout Western North America, with non-travel-associated cases now in British Columbia, Washington, Oregon, and California. Additionally, a secondary outbreak, originating in and still restricted to Oregon, has also occurred. During the past several years, several studies detailing molecular typing, virulence, antifungal susceptibilities, epidemiology, and clinical issues have been published. These studies begin to address the complex dynamics of this novel emergence of a rare and fatal fungus, outline clinical characteristics of human cases, and also opened several new areas that should be explored in the upcoming years.

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Figures

Fig. 1
Fig. 1
Distribution of Cryptococcus gattii infections in Canada and the United States. From 1999–2011, C. gattii infections have been documented in British Columbia (BC), Alberta (AB), Washington (WA), Oregon (OR), California (CA), Hawaii (HI), and North Carolina (NC). Molecular types (VGI-VGIII) and outbreak genotypes (VGIIa, VGIIb, and VGIIc) are listed. All molecular types/genotypes were reported in human cases, with the exception of VGIIb-WA, VGIIb-CA, and VGI-HI. These types have only been found in animal cases to date but are presumed to be endemic in the respective regions and consequently could infect humans. All cases have occurred in western North America with the exception of well-documented travel-associated cases in Alberta and North Carolina
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