Primary cutaneous cryptococcosis on the forearm of an adult human Cryptococcus gattii. Note papule-like lesion, which is beginning to ulcerate. (Courtesy Dr G. Donald, Adelaide, S.A.).
The eastern portion of Vancouver Island, British Columbia is experiencing an outbreak of a rare cryptococcal disease previously known to exist only in tropical and sub-tropical regions.
It is thought that this outbreak on Vancouver Island is the world’s largest outbreak of cryptococcosis ever identified. It is not yet understood how this pathogen, widely regarded as a “tropical” fungus, emerged on Vancouver Island, however changes in the environment and the importation of tropical plants are among the suspected causes (APEC Emerging Infections Network 2004).
In addition to the affected wild and companion animals, over 100 humans have been diagnosed with C. gattii, four of which have died since the onset of the outbreak (updated 2007 to 171 cases with 8 deaths, about 5% death rate from those infected). Because the majority of affected human patients in the Vancouver Island outbreak were immunocompetent, the British Columbia Centre for Disease Control has listed cryptococcal infection as a notifiable disease.
For background information on this encroaching disease see Center for Emerging Issues . There is concern that climate changes have allowed for this disease to take hold on Vancouver Island. This follows the recent appearance of The Nile virus in New Jersey, USA.