The Emergence of Cryptococcus gattii Infections on Vancouver Island and Expansion in the Pacific Northwest
Karen Bartlett
School of Environmental Health, University of British Columbia, Vancouver, BC, Canada, V6T 1Z3
Search for more papers by this authorEdmond Byrnes
Duke University Medical Center, Durham, NC, 27710
Search for more papers by this authorColleen Duncan
Colorado State University Veterinary Diagnostic Laboratory, Fort Collins, CO, 80523
Search for more papers by this authorMurray Fyfe
Office of the Medical Health Officer, Vancouver Island Health Authority, Victoria, BC, Canada, V8R 4R2
Search for more papers by this authorEleni Galanis
British Columbia Centre for Disease Control and School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorJoseph Heitman
Duke University Medical Center, Durham, NC, 27710
Search for more papers by this authorLinda Hoang
British Columbia Centre for Disease Control, Dept. of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorSarah Kidd
Department of Medicine, Monash University, Central Clinical School, Alfred Hospital, Melbourne, VIC 3004 Australia
Search for more papers by this authorLaura Macdougall
British Columbia Centre for Disease Control, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorSunny Mak
British Columbia Centre for Disease Control, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorKieren Marr
Johns Hopkins University School of Medicine, Baltimore, MD, 21205
Search for more papers by this authorMuhammad Morshed
British Columbia Centre for Disease Control, Dept. of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorSarah West
Divisions of General Internal Medicine and Infectious Diseases, Oregon Health and Science University, Portland, OR, 97239
Search for more papers by this authorJames Kronstad
The Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada, V6T 1Z4
Search for more papers by this authorKaren Bartlett
School of Environmental Health, University of British Columbia, Vancouver, BC, Canada, V6T 1Z3
Search for more papers by this authorEdmond Byrnes
Duke University Medical Center, Durham, NC, 27710
Search for more papers by this authorColleen Duncan
Colorado State University Veterinary Diagnostic Laboratory, Fort Collins, CO, 80523
Search for more papers by this authorMurray Fyfe
Office of the Medical Health Officer, Vancouver Island Health Authority, Victoria, BC, Canada, V8R 4R2
Search for more papers by this authorEleni Galanis
British Columbia Centre for Disease Control and School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorJoseph Heitman
Duke University Medical Center, Durham, NC, 27710
Search for more papers by this authorLinda Hoang
British Columbia Centre for Disease Control, Dept. of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorSarah Kidd
Department of Medicine, Monash University, Central Clinical School, Alfred Hospital, Melbourne, VIC 3004 Australia
Search for more papers by this authorLaura Macdougall
British Columbia Centre for Disease Control, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorSunny Mak
British Columbia Centre for Disease Control, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorKieren Marr
Johns Hopkins University School of Medicine, Baltimore, MD, 21205
Search for more papers by this authorMuhammad Morshed
British Columbia Centre for Disease Control, Dept. of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada, V5Z 4R4
Search for more papers by this authorSarah West
Divisions of General Internal Medicine and Infectious Diseases, Oregon Health and Science University, Portland, OR, 97239
Search for more papers by this authorJames Kronstad
The Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada, V6T 1Z4
Search for more papers by this authorJoseph Heitman
Duke University Medical Center, Durham, NC, 27710
Search for more papers by this authorThomas R. Kozel
University of Nevada School of Medicine, Reno, NV, 89557-0320
Search for more papers by this authorKyung J. Kwon-Chung
National Institute of Allergy and Infectious Diseases, Bethesda, MD, 20892
Search for more papers by this authorJohn R. Perfect
Duke University Medical Center, Durham, NC, 27710
Search for more papers by this authorArturo Casadevall
Albert Einstein College of Medicine, Bronx, NY, 10461
Search for more papers by this authorSummary
This chapter outlines issues that were quickly explored, starting with the realization in 2001 that Vancouver Island was a hot spot for a pathogen not previously described as endemic and not restricted to tropical and subtropical climates. The picture of the outbreak that has developed has implications for global travel, climate change, land use patterns, and environmental colonization. Importantly, cryptococcosis caused by Cryptococcus gattii now serves as an excellent illustration of the impact of pathogen spread into a clement ecological niche, in this case, one that happened to be in a major population center of western Canada and the Pacific Northwest. Symptoms and clinicopathological changes in animals on Vancouver Island were consistent with disease reported elsewhere. The most common primary system involved was respiratory, followed by the central nervous system (CNS), in both cats and dogs. Animal cryptococcosis due to C. gattii is a nonregulated disease in Canada. Molecular typing of C. gattii environmental isolates from Vancouver Island using PCR fingerprinting and/or restriction fragment length polymorphism methodologies revealed that the majority of isolates belonged to the VGII molecular type and a small number belonged to the VGI molecular type. A number of solid culture media, biochemical tests, and stains can confirm the diagnosis of Cryptococcus to the genus level. Ecological niche modeling was employed to identify geographical areas in British Columbia with suitable environmental conditions to support the permanent colonization of C. gattii in the environment.
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