Bats in the belfry: an outbreak of histoplasmosis

An Indian lineage of Histoplasma with strong signatures of differentiation and selection

Histoplasma, a genus of dimorphic fungi, is the etiological agent of histoplasmosis, a pulmonary disease widespread across the globe. Whole genome sequencing has revealed that the genus harbors a previously unrecognized diversity of cryptic species. To date, studies have focused on Histoplasma isolates collected in the Americas with little knowledge of the genomic variation from other localities. In this report, we report the existence of a well-differentiated lineage of Histoplasma occurring in the Indian subcontinent. The group is differentiated enough to satisfy the requirements of a phylogenetic species, as it shows extensive genetic differentiation along the whole genome and has little evidence of gene exchange with other Histoplasma species. Next, we leverage this genetic differentiation to identify genetic changes that are unique to this group and that have putatively evolved through rapid positive selection. We found that none of the previously known virulence factors have evolved rapidly in the Indian lineage but find evidence of strong signatures of selection on other alleles potentially involved in clinically-important phenotypes. Our work serves as an example of the importance of correctly identifying species boundaries to understand the extent of selection in the evolution of pathogenic lineages. IMPORTANCE: Whole genome sequencing has revolutionized our understanding of microbial diversity, including human pathogens. In the case of fungal pathogens, a limiting factor in understanding the extent of their genetic diversity has been the lack of systematic sampling. In this piece, we show the results of a collection in the Indian subcontinent of the pathogenic fungus Histoplasma, the causal agent of a systemic mycosis. We find that Indian samples of Histoplasma form a distinct clade which is highly differentiated from other Histoplasma species. We also show that the genome of this lineage shows unique signals of natural selection. This work exemplifies how the combination of a robust sampling along with population genetics, and phylogenetics can reveal the precise genetic changes that differentiate lineages of fungal pathogens.

Occupational Histoplasmosis: Epidemiology and Prevention Measures

In areas where Histoplasma is endemic in the environment, occupations involving activities exposing workers to soil that contains bird or bat droppings may pose a risk for histoplasmosis. Occupational exposures are frequently implicated in histoplasmosis outbreaks. In this paper, we review the literature on occupationally acquired histoplasmosis. We describe the epidemiology, occupational risk factors, and prevention measures according to the hierarchy of controls.

The Monumental Mistake of Evicting Bats from Archaeological Sites—A Reflection from New Delhi

We highlight the importance of an integrated management policy for archaeological monuments and the insect-eating bats that roost inside them. We refer to India, but the issue is general and of worldwide significance. There is increasing evidence that the ecosystem services provided by insect-eating bats in agricultural fields are of vital economic importance, which is likely to increase as chemical pest-control methods become inefficient due to evolving multi-resistance in insects. We visited five archaeological sites in the city of New Delhi. We found bats at all five locations, and three of them harbored large colonies (many thousands) of mouse-tailed bats and tomb bats. These bats likely disperse over extensive areas to feed, including agricultural fields in the vicinity and beyond. All insect-eating bats should be protected and properly managed as a valuable resource at the archaeological sites where they occur. We firmly believe that “fear” of bats can be turned into curiosity by means of education and that their presence should instead enhance the value of the sites. We suggest some means to protect the bats roosting inside the buildings, while mitigating potential conflicts with archaeological and touristic interests.

Epidemiology of Histoplasmosis Outbreaks, United States, 1938-2013

Continued occurrence, particularly in work-related settings, highlights the need to increase awareness of this disease.

Histoplasmosis has been described as the most common endemic mycosis in the United States. However, histoplasmosis is not nationally notifiable. Its presumed geographic distribution is largely derived from skin test surveys performed during the 1940s, and information about its local features comes primarily from outbreak investigations. We conducted a literature review to assess epidemiologic features of histoplasmosis outbreaks in the United States. During 1938–2013, a total of 105 outbreaks involving 2,850 cases were reported in 26 states and the territory of Puerto Rico. Common exposure settings were chicken coops and buildings or other structures undergoing renovation or demolition. Birds, bats, or their droppings were reported to be present in 77% of outbreak settings, and workplace exposures were reported in 41% of outbreaks. The continued occurrence of histoplasmosis outbreaks, particularly work-related ones involving known disturbance of bird or bat droppings, highlights the need to increase awareness of the disease.

Bats and Buildings: The Conservation of Synanthropic Bats

Humans have shared buildings with bats for thousands of years, probably as early as first humans built primitive huts. Indeed, many bat species can be defined as synanthropic, i.e., they have a strong ecological association with humans. Bats have been observed using buildings as roosting and foraging sites, temporary shelters, for reproduction and hibernation. A synanthropic lifestyle may result in direct fitness benefits owing to energetic advantages in warmer roosts, which may ultimately lead to more rapid gestation and faster development of juveniles, or by being less exposed to natural predators in urban environments. All these benefits may allow bats to use buildings as stepping stones to exploit habitats otherwise devoid of roosting structures and may even lead to the expansion of geographic ranges. Yet, the coexistence with humans also comes with some risks. Bats may be exposed to chemical pollutants, particularly preservation chemicals used on lumber or during pest control measures. Bats may also be at risk of direct persecution or they may die accidently if trapped within buildings. In general, eviction of bats from buildings should follow the general rule of avoidance–mitigation–compensation. When considering conservation measures for synanthropic bats, it is most important to assess the role of the building for different life stages of bats. Construction work at buildings should be conducted in a manner that minimizes disturbance of bats. Artificial roosts can replace lost roosts, yet bats will often not accept alternative roosts. Demographic changes in human populations may lead to the abandonment of buildings, for example, in rural areas and to increased conflicts in urban areas when old buildings are replaced by new buildings or when previously unoccupied space in buildings is renovated. We advocate maintenance and enhancement of roosts for synanthropic bats, in addition to outreach and education campaigns, to improve the tolerance of humans for synanthropic bats.

An outbreak and review of cave-associated histoplasmosis capsulati

Three male college students from Florida developed acute onsets of fever, chills, shortness of breath, and cough within one day of each other, and all were eventually hospitalized for four to 29 days. All chest x-ray films showed diffuse reticulonodularities in both lung fields. Laboratory studies confirmed the diagnosis of histoplasmosis. The three students had been 'spelunking' (cave exploring) 6 to 7 days before their onset of symptoms. One of four soil samples collected in the caves was positive for Histoplasma capsulatum by the indirect mouse inoculation procedure. Of three investigators who entered the implicated caves, two developed acute febrile illness within 15-21 days. One investigator was hospitalized for 18 days with a confirmed diagnosis of histoplasmosis. Investigation identified an additional case (the person had entered the caves 6 months before this episode), but was not reported to health authorities. Spelunkers should be aware of the potential risk of histoplasmosis and how to avoid infection. Physicians should be cognizant of cave-associated histoplasmosis, inquire about spelunking in persons who develop febrile respiratory illnesses with diffuse nodularities on chest x-ray films, and report such cases to their health department. A review of 42 reported outbreaks of cave-associated histoplasmosis and the approach to environmental control of infected caves are included.