American Family Stricken by Airborne Fungal Illness Following Visit to Bat-Infested Caverns
In a recent incident, a US family vacationing in Costa Rica visited the bat-colonized Venado Caves, unknowingly putting themselves at risk of contracting histoplasmosis – a potentially severe fungal infection.
The symptoms of histoplasmosis, which can develop after inhaling fungal spores from soil contaminated with bat droppings, include fever, chills, muscle aches, fatigue, headaches, chest pain, and a dry cough. In more severe cases, symptoms may worsen to coughing with bloody or thick yellow sputum, night sweats, shortness of breath, rash, weight loss, or poor feeding in infants [1].
This family's unfortunate encounter with histoplasmosis serves as a stark reminder of the risks associated with cave environments. The primary risk is that the fungal infection can cause respiratory illness, often mild or asymptomatic, but it may become serious, especially if the infection spreads beyond the lungs. Individuals with weakened immune systems, such as young children or those with immune deficiencies, are at higher risk for severe disease [1][5].
The Venado Caves, an ancient cave system and popular tourist destination in Costa Rica, were found to have caused a histoplasmosis outbreak in 1998 and 1999 [7]. The CDC, upon learning about the family's spelunking expedition in the Venado Caves, launched an investigation and published a report in the journal Morbidity and Mortality Weekly Report, detailing 12 confirmed or probable cases of histoplasmosis [6].
Eight family members were probably diagnosed with histoplasmosis, but three were only suspected of having the disease. Two of the family members tested positive for histoplasma [6]. Doctors usually prescribe antifungal medication for patients with severe histoplasmosis, but many cases in healthy individuals go away on their own [2].
The CDC is collaborating with the U.S. Embassy in Costa Rica and the Costa Rica Ministry of Health to include the risk of histoplasmosis in the Venado Caves tour waiver forms [8]. This move aims to ensure that visitors are aware of the potential risks associated with visiting bat-colonized caves.
Interestingly, the popular game The Last of Us seems to draw inspiration from real-life incidents of histoplasmosis and its symptoms. Andrzej Sapkowski, author of The Witcher, wrote that "there's a grain of truth in every fairy tale." [3]
This clinical picture aligns with documented cases of histoplasmosis from cave visits in endemic areas such as Costa Rica, where bat habitats are common. It serves as a cautionary tale for travellers to be mindful of the potential risks associated with visiting bat-colonized caves.
References:
[1] Centers for Disease Control and Prevention. (2022). Histoplasmosis. Retrieved 17 March 2023, from https://www.cdc.gov/fungal/diseases/histoplasmosis/index.html
[2] Centers for Disease Control and Prevention. (2022). Treatment for Histoplasmosis. Retrieved 17 March 2023, from https://www.cdc.gov/fungal/diseases/histoplasmosis/treatment.html
[3] Kot, K. (2013). The Last of Us: The Making of a Post-Apocalyptic Masterpiece. Retrieved 17 March 2023, from https://www.wired.com/2013/06/the-last-of-us-the-making-of-a-post-apocalyptic-masterpiece/
[4] National Park Service. (2022). Cave Safety. Retrieved 17 March 2023, from https://www.nps.gov/subjects/caves/safety.htm
[5] Centers for Disease Control and Prevention. (2022). People at High Risk for Severe Disease. Retrieved 17 March 2023, from https://www.cdc.gov/fungal/diseases/histoplasmosis/people-at-high-risk.html
[6] Centers for Disease Control and Prevention. (2022). Histoplasmosis Outbreak — Costa Rica, 2021. Retrieved 17 March 2023, from https://www.cdc.gov/mmwr/volumes/71/wr/mm7116e1.htm
[7] Centers for Disease Control and Prevention. (1999). Histoplasmosis Outbreak — Costa Rica, 1998. Retrieved 17 March 2023, from https://www.cdc.gov/mmwr/volumes/48/wr/mm4836a3.htm
[8] Centers for Disease Control and Prevention. (2022). Histoplasmosis Outbreak — Costa Rica, 2021. Retrieved 17 March 2023, from https://www.cdc.gov/mmwr/volumes/71/wr/mm7116e1.htm
- The popular video game The Last of Us appears to draw inspiration from real-life cases of histoplasmosis and its symptoms.
- The US family's visit to the bat-colonized Venado Caves in Costa Rica served as a sobering reminder of the risks associated with cave environments.
- The game's author, Andrzej Sapkowski, once stated that "there's a grain of truth in every fairy tale."
- The CDC is collaborating with relevant authorities in Costa Rica to ensure that visitors are aware of the potential risks of histoplasmosis when visiting bat-colonized caves.
- In addition to travel, topics like health, science, technology, medical-conditions, respiratory-conditions, health-and-wellness, fitness-and-exercise, mental-health, lifestyle, and travel are all interconnected, as demonstrated by this incident.
- Understanding the symptoms of histoplasmosis, which include fever, chills, muscle aches, and a dry cough, among others, can help in early detection and treatment of the condition.
