Stories From the Field

Alert Montana disease detective identifies the suspect: Cryptococcus gattii

In response to increasing numbers of cases of Cryptococcus gattii in the US Pacific Northwest, the northwest states (OR, WA, MT, ID, and AK) formed a Working Group in 2008 to address this public health nemesis. Cryptococcus gattii is a fungal organism that causes a variety of serious infections ranging from pneumonia to brain abscesses and meningitis. The goals were to increase awareness about the new infection and begin to conduct surveillance for cases of disease.

In 2009, the working group and CDC initiated standardized, laboratory-based surveillance across the northwest states. Although all states were active participants in the working group, nearly all C. gattii cases came from Washington and Oregon. In spite of this, the other Pacific Northwest states remained heavily engaged and continued to educate their health care providers and public health staff about C. gattii.

In late 2010, Montana identified their first case of C. gattii infection, thanks in large part to the continued efforts of Dr. Randall Nett, who initially led the surveillance and education efforts in Idaho, and later in Montana. Dr. Nett worked with health care providers to spread the word about C. gattii. Due to his efforts, an astute clinician realized that the cryptococcal infection in his healthy patient could be due to C. gattii and alerted the state health department, who reported the infection to CDC. Interestingly, that case is probably not linked to the outbreak in Washington and Oregon, adding to a growing body of evidence that outbreak- and non-outbreak-associated C. gattii strains are ongoing health issues in the United States.