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. 2017 Oct 5;43(10):200-205.
doi: 10.14745/ccdr.v43i10a02.

Blastomycosis hospitalizations in northwestern Ontario: 2006-2015

S Litvinjenko  1 , D Lunny  2
Affiliations

Blastomycosis hospitalizations in northwestern Ontario: 2006-2015

S Litvinjenko et al. Can Commun Dis Rep. .

Abstract

Background: Blastomycosis, caused by the organism Blastomyces dermatitidis, is an invasive fungal disease found in Central Canada and Central and Midwestern United States.

Objective: To describe trends in and epidemiology of hospitalized cases of blastomycosis cases reported among northwestern Ontario residents between 2006 and 2015.

Methods: Blastomycosis hospitalization data were extracted from the Discharge Abstract Database (DAD), accessed through IntelliHEALTH Ontario. The DAD includes administrative, clinical and demographic information on hospital discharges provided by the Canadian Institute for Health Information (CIHI). Blastomycosis records were identified using ICD-10 codes B40.0 to B40.9. Hospitalization rates were calculated for all of Ontario, and age-specific hospitalization rates were calculated for northwestern Ontario and analyzed by local health region, time and seasonality as well as presenting symptoms.

Results: There were 581 hospitalizations for blastomycosis reported in Ontario over this 10-year period. Of these, 245 (42%) were from northwestern Ontario, although this region accounts for only 0.6% of the Ontario population. The average hospitalization rate for blastomycosis in northwestern Ontario was 35.0 per 100,000 per year. This rate varied from 1.7 in the Red Lake region to 57.9 in the Kenora region. The most common presentation was acute pulmonary symptoms. Men were 1.36 times more likely to be hospitalized for blastomycosis than were women (95% confidence interval [CI]: 1.06-1.75, P<0.05). Most hospitalizations were registered in the late fall months, suggesting blastomycosis exposure in the spring/summer season followed by a lengthy incubation period.

Conclusion: Areas of northwestern Ontario have high reported rates of blastomycosis. It is not known to what extent there are regional differences in other states and provinces. Interregional differences may warrant prioritizing strategies for blastomycosis prevention and control as well as additional research and surveillance.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1. Number of blastomycosis hospitalizations by public health unit, Ontario, 2006–2015 (n=581)
Source: Inpatient Discharges 2006-2015. Ontario Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Date Extracted: January 10, 2017
Figure 2
Figure 2. Blastomycosis hospitalizations* by northwestern Ontario region†, 2006–2015
* Rates per 100,000 per year age standardized, with 95% confidence intervals † Regions include the named municipality in addition to smaller nearby communities and First Nation reserves Note: Results from Red Lake, Emo and Atikokan were omitted due to small counts Source: Inpatient Discharges 2006–2015. Ontario Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Date Extracted: January 10, 2017
Figure 3
Figure 3. Blastomycosis hospitalization rates* by age and sex, northwestern Ontario, 2006–2015
*Rates per 100,000 per year with 95% confidence intervals Source: Inpatient Discharges 2006–2015. Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Date Extracted: January 10, 2017
Figure 4
Figure 4. Blastomycosis hospitalizations by ICD-10 diagnosis code, northwestern Ontario, 2006–2015
Source: Inpatient Discharges 2006–2015. Ontario Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Date Extracted: January 10, 2017
Figure 5
Figure 5. Blastomycosis hospitalizations in northwestern Ontario by year, 2006–2015
Source: Inpatient Discharges 2006–2015. Ontario Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Date Extracted: January 10, 2017
Figure 6
Figure 6. Blastomycosis hospitalizations in northwestern Ontario by month, 2006–2015 (n=245)
Source: Inpatient Discharges 2006–2015. Ontario Ministry of Health and Long-Term Care. IntelliHEALTH Ontario. Date Extracted: January 10, 2017
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