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Sporotrichosis Among Hay-Mulching Workers -- Oklahoma, New Mexico

Between June and September 1983, 12 cases of cutaneous sporotrichosis occurred among persons who had worked on three different hay-mulching crews based in Oklahoma and New Mexico. Each crew had used hay from the same fields in south-central Oklahoma to mulch road banks and building sites.

A private physician notified the Oklahoma Department of Health of one worker hospitalized for investigation of possible pulmonary sporotrichosis. Other cases were identified through reports from physicians and a survey of the six hay-mulching companies operating in Oklahoma and New Mexico. A case was defined as a person with a cutaneous lesion and serologic evidence of Sporothrix schenckii infection.

Three of five workers in a crew working in northern Texas developed S. schenckii infections; in another crew working in southern New Mexico, four of 12 workers developed infections; in a third crew working in central New Mexico, five of 21 workers who responded to a questionnaire developed infections. None of the patients had been exposed outside their work to roses, sphagnum moss, or hay. Ten of 12 patients had one or more lesions on the upper extremities; one of the remaining two had a single lesion on the upper chest; and the other, a single lesion on the lateral eyelid. Two additional workers had positive serologic tests but no clinical manifestations.

A questionnaire was administered to members of the three crews; 79% of the workers responded. No association was found between clinical infection and duration of work or work duty (loader, hay-blower, or driver). Exposure to fresh hay was not associated with infection in six workers who cut and baled hay at the implicated fields.

The prairie hay used by the crews had been cut in August 1982. Normally, prairie hay is dried for 1-2 days in the field before baling, but because of rain, this crop was left in the field for 5-6 weeks before being baled; after baling, it was stored until May 1983. Samples obtained from soil and plants at the implicated field 2 months after the hay mulching were negative for S. schenckii. Reported by W Cook, MD, DJ Sexton, MD, Oklahoma City, B Gildon, J Booher, Comanche County Health Dept, P Hawkins, MPH, T Rickman, G Istre, MD, State Epidemiologist, Oklahoma State Dept of Health; V Ornelus, MD, P Acerra, Lovinn, I Nash, MD, Albuquerque, S Kearns, W Ricer, Carlsbad, R Ferguson, J Mann, MD, H Hull, MD, State Epidemiologist, New Mexico Health and Environment Dept; Div of Mycotic Diseases, Special Pathogens Br, Div of Bacterial Diseases, Center for Infectious Diseases, Div of Field Svcs, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: S. schenckii is a dimorphic fungus. It is found worldwide in soil, plants, and decaying vegetation. Cutaneous sporotrichosis follows inoculation of spores into the skin and subcutaneous tissue. Infections of joints, central nervous system, and lungs occur, but are rare. Sporotrichosis following occupational exposure has been described previously among forestry workers (1), horticulturists, and miners (2,3). Infection following occupational exposure to prairie hay has not previously been reported, but two outbreaks have been described among children playing in old prairie hay (4,5). Health professionals attending workers with occupational exposure to decaying plant matter, including hay, should be alert for sporotrichosis as a cause of chronic skin disease.

References

  1. Powell KE, Taylor A, Phillips BJ, et al. Cutaneous sporotrichosis in forestry workers. Epidemic due to contaminated sphagnum moss. JAMA 1978;240:232-5.

  2. Conant NF. Medical mycology: Sporotrichum schenckii. In: Dobos RJ, Hirsch JG, eds. Bacterial and mycotic infections of man. 4th ed. Philadelphia: JB Lippincott Company, 1965:853-6.

  3. CDC. Sporotrichosis associated with Wisconsin sphagnum moss. MMWR 1982:31;542-4.

  4. Dahl BA, Silberfarb PM, Sarosi GA, Weeks RJ, Tosh FE. Sporotrichosis in children. Report of an epidemic. JAMA 1971;215:1980-2.

  5. Laur WE, Posey RE, Waller JD. A familial epidemic of cutaneous sporotrichosis occurring in North Texas. Cutis 1979;23:205-8.



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