April 11, 2001

SPRINGFIELD, IL – An outbreak of acute respiratory illness among U.S. travelers to Acapulco, Mexico, last month has been reported by the U.S. Centers for Disease Control and Prevention (CDC). Ninety-eight suspected cases have occurred in students from 37 schools in 18 states, including Illinois.

The source of the exposure has not yet been determined, but preliminary information has revealed that all ill persons either stayed in or spent time on the premises of the Calinda Beach Hotel in Acapulco between March 3 and March 18.

The cluster of cases was reported to CDC after a number of U.S. university students, who visited Acapulco during March spring breaks, sought medical care for acute respiratory illness, with symptoms that included high fever, headache, dry cough and chills. While laboratory testing for the cause of the illness is ongoing, initial tests indicate it is probably histoplasmosis, a disease caused by a fungus that primarily affects the lungs. Histoplasmosis is not transmitted from an infected person to someone else.

CDC has said two students have preliminary test results suggesting the etiology of their illnesses is Histoplasma capsulatum. One had a tissue culture with mycelial forms of the organism, and the other had positive GMS stain showing numerous yeasts consistent with Histoplasma capsulatum. Several students have also had positive serologies for Mycoplasma pneumoniae.

Eighteen of 22 students from the University of Illinois at Urbana-Champaign who visited Acapulco reported some type of illness and two were hospitalized. Four Eastern Illinois students and three from Illinois State University also have reported respiratory illness, but none required hospitalization. In addition, two students from Illinois who attend Washington University in St. Louis reported illness. Serum samples have been collected from 16 of the U of I students and sent to CDC for testing, but no laboratory confirmed diagnosis has been made.

CDC is recommending the use of "Practice Guidelines for the Management of Patients with Histoplasmosis," Clinical Infectious Diseases, 2000;30:688-95 for management of patients. The document is available at http://www.idsociety.org/pg/histo.pdf. CDC is requesting acute and convalescent serum from those meeting the case definition (fever for three days, plus one of the following -- dry cough, shortness of breath or chest pain).

U.S. travelers to Acapulco during March, especially students who visited or stayed in the Calinda Beach Hotel, should consult a primary health care professional if symptoms develop. Additional cases should be promptly reported to the appropriate local health department.