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Occcupational and recreational risks for histoplasmosis – prevention measures

December 06 2018

Blackbird nesting in a bamboo grove

Risks of acquiring histoplasmosis  can be minimised according to a review by James Diaz of the Louisiana School of Public Health. In endemic areas, high-risk settings for contracting histoplasmosis include empty buildings (because they often end up as nesting sites for birds), chicken coops, farms, stream banks, golf courses, amusement parks, and tennis complexes. Birds or bird droppings and bats or their droppings are usually reported in histoplasmosis outbreaks. The most common birds (in the USA) associated with histoplasmosis are blackbirds (including crows and starlings), chickens, pigeons and occasionally seagulls.

Recommendations for avoiding histoplasmosis in workers have been formulated by the US National Institute of Occupational Safety and Health (NIOSH ). Workers who disrupt contaminated soils or accumulations of bird or bat droppings should a) exclude birds or bats from buildings, if possible; b) provide warnings about health risks to workers, and other contractors who may visit with signage; c) control dust by wetting surfaces during construction, demolition, or excavation in endemic areas; d) properly dispose of all contaminated wastes (and warn those handling this waste); as well as e) select and wear appropriate personal protective equipment, notably high quality masks or full protective gear, depending on the likely contamination intensity.

Other activities may be risky in endemic areas. Visiting caves or any other areas with high concentrations of bird or bat droppings should prompt consideration of using personal protective equipment, including gloves, protective clothing, and respirators, or high-quality masks. Bamboo groves or upright structures with birds roosting are a risk if near residences and schools Removal and disposal may prevent local cases. Keeping backyard chickens or racing pigeons may be risky activities in endemic areas, and families should at least use high-quality masks if cleaning out.

References

Environmental and Wilderness-Related Risk Factors for Histoplasmosis: More Than Bats in Caves. Diaz JHWilderness Environ Med. 2018 Dec;29(4):531-540.

US Centers for Disease Control and Prevention. Histoplasmosis: Protecting Workers at Risk. Department of Health and Human Services, National Institute of Occupational Safety and Health (NIOSH) Publication No. 2005-109. Atlanta, GA: CDC; 2004.