Molly Bradshaw, UHL public health microbiologist, performs testing for histoplasmosis using complement fixation methods. Histoplasmosis is a fungal infection caused by Histoplasma capsulatum.

Histoplasmosis is a respiratory illness, caused by a fungus often found in the soil where bird droppings are located or in bat feces. The infectious particles of the fungus are transmitted through the air. If inhaled by susceptible individuals, they may produce the disease. Histoplasmosis is not contagious; it cannot be transmitted from one person to another.

Most exposed persons have no ill effects. In some cases, histoplasmosis can cause respiratory symptoms, including a dry or nonproductive cough, chest pains, fever and a general ill feeling symptoms often associated with common respiratory viruses. Mild cases are usually resolved without treatment. Antifungal medications are used to treat severe cases.

The investigation will include environmental testing of Terrace Hill and offering screenings to residents, staff, construction workers, landscapers and visitors who were at the mansion November 29, 2007. Because exposure to histoplasmosis usually occurs over a short period of time, the investigation is focused on November 29, 2007. "At this time, we have no reason to believe exposure occurred on any other dates," says IDPH Director Tom Newton. "It's important to note that over 90 percent of people exposed to histoplasmosis have no symptoms or symptoms so mild that medical attention is not necessary. Most people with symptoms do not need medication."

Courtney Greene, press secretary for Governor Culver says, "The Governor and First Lady have been briefed on the situation and are confident that health officials are acting swiftly and appropriately."

Newton says potential exposures to histoplasmosis may have occurred involving landscaping, renovations and other activities in and around Terrace Hill November 29, 2007. He says as the investigation continues, additional notifications may be necessary.

People who visited Terrace Hill on the date of November 29, 2007 should call 866-923-1089 for screening and follow-up as necessary. Because this is not an emergency, the phone line will be open during normal business hours, 8:00 a.m. until 4:30 p.m.

For information about histoplasmosis, go to http://www.idph.state.ia.us/adper/histoplasmosis.asp.

Comments From UHL:
"As the state public health laboratory, the UHL assisted in the investigation of this outbreak by conducting tests to confirm the diagnosis of histoplasmosis, and we will continue to support the Iowa Department of Public Health as it oversees the epidemiology and as it identifies treatment for those affected," says UHL Director Christopher Atchison. "The UHL is unique within Iowa in its ability to provide this kind of testing. Having this capacity in the state makes testing much more expeditious."

UHL Associate Director of Infectious Disease Dr. Michael Pentella explains that "the Midwest is an endemic area for histoplasmosis. The organism is known to be in our part of the country. Some cases are asymptomatic or mild and others can be more severe. For patients with the illness, it is typically treated with an antifungal agent.

"We perform two tests as part of the confirmatory process: micro-immunodiffusion, which gives us the positive or negative reading, and a complement fixation assay, which allows us to narrow down the stage of the disease and the time of exposure. These two steps combined provide extremely accurate results within a short period of time."