Outbreak of Histoplasmosis in a School Party That Visited a Cave in Belize: Role of Antigen Testing in Diagnosis

Histoplasmosis is endemic in parts of South and Central America and the role of bat guano is widely recognized in promoting the growth of the organism.1,2 Previous outbreaks have been reported among cavers in the United States3,4 and South America,5 often in travelers upon return to their home country.The illness may be quite severe, as the exposure is often extensive,emphasizing the importance of recognition of the risk for histoplasmosis in cavers and understanding the approach to diagnosis. Thirteen students (aged 16 to18 years) and 2 teachers from a school in Trail,British Columbia,Canada, traveled in Belize with 2 guides (1 Canadian,1 from Belize) from March 16 to 26,2000.Local BC physicians reported complaints of fever and chills in returning travelers to the BC Centre for Disease Control (BCCDC). Method