The NSS Bulletin - ISSN 1090-6924
Volume 51 Number 1: 52-65 - June 1989

A publication of the National Speleological Society

Histoplasmosis: A Hazard to New Tropical Cavers
Warren C. Lewis, MD

Abstract

Each new generation of cave explorers wishing to cave in Mexico or the tropics has to face the possibility of sickness from histoplasmosis. Even modest exposure in a tropical cave may result in incapacitating illness. In order to gain immunity it is desirable for the first exposure to be as light as possible. If the amount of initial exposure is misjudged, results maybe serious. The fungus is found in tropical and semi-tropical caves around the world and to a lesser degree in temperate zone caves. Many caves known to be infected are reported here along with a review of some of the epidemics associated with them. While over 90% of all epidemics originate from contact with birds and bird excreta, a significant number originate in caves. If the caver comes from the northern part of the United States or from Canada, England, or other countries of northern Europe, he is likely to lack immunity. Cave scientists, archeologists, northern mining engineers, and newly-employed guano miners are especially at risk. Some suggestions have been made as to ways to minimize initial exposure. Finally, thought is given to the possible development of a protective vaccine.

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