A recent outbreak among American missionaries in El Salvador is the latest in a growling list of histoplasmosis outbreaks acquired during travel to endemic areas. The following chronology is abstracted from GIDEON (primary references available on request) Additional cases of travel-related African histoplasmosis (caused by Histoplasma capsulatum var. duboisii ) appear at the bottom of the list :

1984 (publication year) – A case of imported infection (from India) was reported in Scotland.
1986 (publication year) – Disseminated histoplasmosis has been reported in an immigrant to the United States from the Dominican Republic.
1989 (publication year) – A German national developed disseminated histoplasmosis following a trip to Ecuador.
1993 – An outbreak (5 cases) was reported among Japanese tourists following a visit to a cave in Brazil.
1994 – An outbreak (24 cases) among French tourists to New Caledonia was ascribed to a bat-infested cave.
1995 (publication year – A Dutch traveler acquired histoplasmosis in Honduras.
1995 – An outbreak (13 cases) was reported among French tourists, after ‘trekking’ through a mountain tunnel in Martinique.
1997 (publication year) – A Dutch traveler acquired histoplasmosis in Guatemala.
1998 to 1999 – Outbreaks (42 citizens, and 9 tourists from the United States and Canada) acquired acute pulmonary histoplasmosis in a cave in Costa Rica.
2000 – An outbreak (14 cases) involved a group of Canadian students who had been exploring a bat-infested cave in Belize.
1999 – An outbreak (6 cases) of acute histoplasmosis was reported among Chilean travelers who visited a cave in Ecuador.
2001 – An outbreak (4 cases) was reported among German scientists following visit to a cave in Cuba.
2001 (publication year) – An outbreak (2 cases) was reported among Japanese tourists following a tour of caves in Mexico.
2001 – An outbreak (262 cases) occurred among American college students while at a hotel in Acapulco. 18 180 Mexicans were also infected at the hotel during the same period, and additional Mexicans were infected at the hotel later the same year. A third outbreak (227 cases) affected convention attendees at the same hotel that year.
2001 – An outbreak (14 cases) was reported among American adventure tourists exploring bat-infested cave in Nicaragua.
2003 (publication year) – A Spanish tourist acquired histoplasmosis in Ecuador.
2004 (publication year) – Histoplasmosis was reported in Belgian nationals who had previously lived in Africa.
2004 – An outbreak (8 confirmed cases) was reported among Norwegian tourists to Central America.
2005 (publication year) – An outbreak (9 cases) was reported among Spanish volunteers who had worked on a construction site in Guatemala.
2005 – An outbreak (4 cases) was reported among Spainish tourists in Ecuador.
2006 (publication year) – A Dutch traveler acquired histoplasmosis in Ghana.
2006 – An outbreak (10 cases) of acute histoplasmosis was reported among Italian researchers who had visited a Rain Forest in Ecuador.
2006 – An outbreak (3 cases) was reported among German scientists following visit to a cave in Trinidad.
2007 (publication year) – A case of pulmonary histoplasmosis in Japan was imported from Bolivia
2007 (publication year) – An outbreak (3 cases) was reported among Austrian travelers who were exposed to a bat cave in Mexico.

African histoplasmosis:
1990 – A case of imported African histoplasmosis reported in Chile, was acquired in Ivory Coast.
1992 to 2001 – – Three cases (1992, 1996 and 2001) of African histoplasmosis in HIV-positive immigrants from Democratic Republic of Congo were reported in France.
1996 (publication year) – African histoplasmosis was diagnosed in a Liberian immigrant living in Switzerland.

Update: Reported in ProMED

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