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MMWR Morb Mortal Wkly Rep. 2014 Jan 3;62(51-52):1041-4.

Histoplasmosis outbreak associated with the renovation of an old house - Quebec, Canada, 2013.


On May 19, 2013, a consulting physician contacted the Laurentian Regional Department of Public Health (Direction de santé publique des Laurentides [DSP]) in Quebec, Canada, to report that two masons employed by the same company to do demolition work were experiencing cough and dyspnea accompanied by fever. Other workers also were said to be ill. DSP initiated a joint infectious disease, environmental health, and occupational health investigation to determine the extent and cause of the outbreak. The investigation identified 14 persons with respiratory symptoms among 30 potentially exposed persons. A strong correlation was found between exposure to demolition dust containing bat or bird droppings and a diagnosis of histoplasmosis. Temporary suspension of construction work at the demolition site in Saint-Eustache, Quebec, northwest from Montreal, and transport of the old masonry elements to a secure site for burial were ordered, and information about the disease was provided to workers and residents. To prevent future outbreaks, recommendations included disinfection of any contaminated material, disposal of waste material with proper control of aerosolized dust, and mandatory use of personal protective equipment such as gloves, protective clothing, and adequate respirators.

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