Sporotrichosis Among Hay-Mulching Workers -- Oklahoma, New Mexico
Between June and September 1983, 12 cases of cutaneous
sporotrichosis occurred among persons who had worked on three
different hay-mulching crews based in Oklahoma and New Mexico.
Each
crew had used hay from the same fields in south-central Oklahoma to
mulch road banks and building sites.
A private physician notified the Oklahoma Department of Health
of
one worker hospitalized for investigation of possible pulmonary
sporotrichosis. Other cases were identified through reports from
physicians and a survey of the six hay-mulching companies operating
in
Oklahoma and New Mexico. A case was defined as a person with a
cutaneous lesion and serologic evidence of Sporothrix schenckii
infection.
Three of five workers in a crew working in northern Texas
developed S. schenckii infections; in another crew working in
southern
New Mexico, four of 12 workers developed infections; in a third
crew
working in central New Mexico, five of 21 workers who responded to
a
questionnaire developed infections. None of the patients had been
exposed outside their work to roses, sphagnum moss, or hay. Ten of
12
patients had one or more lesions on the upper extremities; one of
the
remaining two had a single lesion on the upper chest; and the
other, a
single lesion on the lateral eyelid. Two additional workers had
positive serologic tests but no clinical manifestations.
A questionnaire was administered to members of the three crews;
79% of the workers responded. No association was found between
clinical infection and duration of work or work duty (loader,
hay-blower, or driver). Exposure to fresh hay was not associated
with
infection in six workers who cut and baled hay at the implicated
fields.
The prairie hay used by the crews had been cut in August 1982.
Normally, prairie hay is dried for 1-2 days in the field before
baling, but because of rain, this crop was left in the field for
5-6
weeks before being baled; after baling, it was stored until May
1983.
Samples obtained from soil and plants at the implicated field 2
months
after the hay mulching were negative for S. schenckii.
Reported by W Cook, MD, DJ Sexton, MD, Oklahoma City, B Gildon, J
Booher, Comanche County Health Dept, P Hawkins, MPH, T Rickman, G
Istre, MD, State Epidemiologist, Oklahoma State Dept of Health; V
Ornelus, MD, P Acerra, Lovinn, I Nash, MD, Albuquerque, S Kearns, W
Ricer, Carlsbad, R Ferguson, J Mann, MD, H Hull, MD, State
Epidemiologist, New Mexico Health and Environment Dept; Div of
Mycotic
Diseases, Special Pathogens Br, Div of Bacterial Diseases, Center
for
Infectious Diseases, Div of Field Svcs, Epidemiology Program
Office,
CDC.
Editorial Note
Editorial Note: S. schenckii is a dimorphic fungus. It is found
worldwide in soil, plants, and decaying vegetation. Cutaneous
sporotrichosis follows inoculation of spores into the skin and
subcutaneous tissue. Infections of joints, central nervous system,
and lungs occur, but are rare. Sporotrichosis following
occupational
exposure has been described previously among forestry workers (1),
horticulturists, and miners (2,3). Infection following
occupational
exposure to prairie hay has not previously been reported, but two
outbreaks have been described among children playing in old prairie
hay (4,5). Health professionals attending workers with
occupational
exposure to decaying plant matter, including hay, should be alert
for
sporotrichosis as a cause of chronic skin disease.
References
Powell KE, Taylor A, Phillips BJ, et al. Cutaneous
sporotrichosis
in forestry workers. Epidemic due to contaminated sphagnum
moss.
JAMA 1978;240:232-5.
Conant NF. Medical mycology: Sporotrichum schenckii. In:
Dobos
RJ, Hirsch JG, eds. Bacterial and mycotic infections of man.
4th
ed. Philadelphia: JB Lippincott Company, 1965:853-6.
CDC. Sporotrichosis associated with Wisconsin sphagnum moss.
MMWR 1982:31;542-4.
Dahl BA, Silberfarb PM, Sarosi GA, Weeks RJ, Tosh FE.
Sporotrichosis in children. Report of an epidemic. JAMA
1971;215:1980-2.
Laur WE, Posey RE, Waller JD. A familial epidemic of cutaneous
sporotrichosis occurring in North Texas. Cutis 1979;23:205-8.
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