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Guano With the Wind

Airborne spores in bat, bird feces may cause 'Acapulco Flu'

FRIDAY, May 18, 2001 (HealthDayNews) -- If you're traveling to Acapulco anytime soon, you might want to avoid the Calinda Beach Hotel.

American students staying there in March were nearly 14 times more likely than students at other hotels to get histoplasmosis, a respiratory infection, reports the Centers for Disease Control and Prevention (CDC) in Atlanta, Ga. And reports of illness still are trickling in from travelers who stayed at the hotel weeks later.

"The outbreak is still ongoing," says Dr. Maria Cano, a CDC epidemic intelligence officer. "It would be best to avoid staying at the hotel."

The CDC has been issuing health advisories on the outbreak for weeks, since Pennsylvania health authorities first noticed a cluster of histoplasmosis problems among college students who'd traveled to Acapulco for spring break. A recent Morbidity and Mortality Weekly Report (MMWR), published by the CDC, says 229 students from 44 colleges and 22 states have been diagnosed with the illness.

In addition, a couple from California who stayed at the hotel in April developed acute histoplasmosis, and a group of high school students from Washington who lodged at the hotel over Easter may also be ill, Cano says. And Mexican authorities have begun reporting accounts of Mexican tourists who stayed at the hotel and became ill.

Histoplasmosis causes fever for at least three days, with coughing, shortness of breath, chest pain or headache.

Severity of the illness depends on your exposure and your own health, says Dr. Joseph Wheat, professor of medicine at the Indiana University School of Medicine's Division of Infectious Diseases. For instance, Indianapolis has had a number of histoplasmosis outbreaks since the 1970s; 100,000 people are believed to have been contaminated in one outbreak, Wheat says.

Most of those contaminated may not have known and would not need to be treated at all, he says. Those with fragile immune systems are another story. "The AIDS patient or kidney transplant patient often isn't able to handle the infection, and it can spread and ultimately prove to be fatal," Wheat says.

Some outbreaks in Indianapolis were attributed to downtown urban renewal construction, although Cano says the CDC found no contamination at the construction sites or nearby bird and bat roosts.

The infection is caused by Histoplasma capsulatum, a fungus that grows in dirt contaminated with bat or bird droppings. When the soil is disturbed, spores from the mold can become airborne. Breathing as few spores as would fill 1/10,000 of a pencil mark could infect a person, Wheat says. You can't catch it from another person.

The CDC also questioned 109 random students who'd traveled to Acapulco and stayed at three other hotels during the first two weeks of March. Of 31 students who stayed at the Calinda Beach Hotel, 22 developed histoplasmosis, compared with 4 of 78 who stayed at other hotels. The students who stayed at the Calinda Beach Hotel were 13.8 times more likely to develop the illness than other students, says the CDC.

The CDC is now sending questionnaires to people who traveled to Acapulco, trying to determine if those who got sick had any activities in common, Cano says.

What To Do

For the full MMWR report on the histoplasmosis outbreak, try the CDC. The CDC also has more info on histoplasmosis.

You can read more about illnesses in the tropics at HealthDay.

SOURCES: Interviews with Maria Cano, M.D., M.P.H., CDC epidemic intelligence officer, Atlanta, Ga.; Joseph Wheat, M.D., professor of medicine, Indiana University School of Medicine's Division of Infectious Diseases; May 11, 2001, MNWR
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