Damp buildings

often have a moldy smell or obvious mold growth, and some molds are known human pathogens. This has caused concern regarding potential health effects of moldy indoor environments. As a result, there have been many studies of moisture- and mold-damaged buildings. More recently, there have been a growing number of articles in the media and of lawsuits claiming severe illness as a result of indoor mold exposure, particularly to Stachybotrys chartarum. However, while many authors report a clear relationship between fungal contaminated indoor environments and illness, close examination of the literature reveals a much more confusing picture. In this review, we discuss indoor environmental mold exposure and mycotoxicosis, with an emphasis on S. chartarum and its toxins (due to the breadth of the topic, we will not discuss better understood areas such as invasive disease caused by Aspergillus). We also discuss specific organ effects, focusing on illnesses purportedly caused by indoor mold. These illnesses include pulmonary, immunologic, neurologic, and oncologic disorders. We discuss the Cleveland infant idiopathic pulmonary hemorrhage (IPH) reports in some detail, since they provided much of the fuel for current concerns about Stachybotrys exposure. As we will see, while there is cause for concern about the potential effects of indoor mold exposure, particularly to Stachybotrys species, there is no well-substantiated evidence linking the presence of this fungus to health concerns elaborated in the scientific and lay press. As patients and society at large become increasingly concerned that illnesses may be due to the home or work environment, an understanding of mycotoxins by microbiologists and clinicians (especially infectious-disease subspecialists) is of growing importance. Such knowledge is critical to the diagnosis of potential fungus-related disease and is necessary to assuage fears instilled by extensive media coverage

Sausage with mould leads to €6,000 penalty

A mouldy batter sausage led to fines totalling €6,000 for an Enniscorthy takeaway as the HSE brought a prosecution to the District Court last Wednesday. Defendant Kenan Dzhavidov, trading as Denis's Kebab House of Castle Hill, was not present for the proceedings. Evidence was given by his customers Ray Healy and Suzanne Ryan of 11 Ashgrove in The Paddock. Healy told the court how he ordered a takeaway for home delivery on January 6 last year. Ms. Ryan described how she applied salt, vinegar and red sauce to the batter sausage which she began to eat while watching television. She applied more condiments after noticing that the sausage did not taste as normal but this had no effect and she then saw a hairy black mould. She threw the sausage on the floor and vomited. Her partner preserved the sausage in the fridge. When there was no satisfactory explanation or apology from the takeaway the following day, he put it in the freezer and notified the health service. In court, environmental health officer Avril Beaumont confirmed that the sausage was sent for analysis at a laboratory in Cork. The lab test suggested that the black mould was aspergillus and that it was on the food before cooking. The incident prompted Ms. Beaumont to pay a call to the premises in Castle Hill on January 17 last year. She discovered that batter sausages were being par-cooked and then cooled overnight. She reckoned that this was poor procedure and that that anything left longer than two and a half hours should either be chilled or thrown out, for fear that mould could form. She also noted that solid fat was being stored in the potentially unhygienic toilet. Judge Gerard Haughton felt that the offences described were serious, the more so as the accused did not attend court. For serving unfit food, he recorded a €2,000 fine. Similar penalties were imposed for the unsafe method of preparing the batter sausages and for inappropriate storage of the fat. Witness expenses of €100 were awarded and Dzhavidov was further ordered to meet the HSE's legal costs. Source: http://www.independent.ie

Mould in Library

Attending to an infestation Staff suffering from allergies or respiratory problems should not attend to mould infestations. Mould can be checked to see whether it is active or inactive. Generally, active mould is damp, slimy, and smears if touched. Inactive mould is dry and powdery and can be brushed off with a soft brush. If mould is discovered in large portions of a collection, isolate the area immediately and do not attempt to clean up without first consulting Library Conservation and Collection Care Service. Certain moulds can pose serious health risks, causing headaches, nausea, eye and skin irritation, and respiratory problems. Library Conservation and Collection Care Service may have to be employed or at least consulted on the treatment of infested items and on the return of the affected area to a suitable condition for housing material. If only a few items are affected, place them in a dry paper-based box until treatment. If possible, include a desiccant, such as conditioned silica gel packets. This enclosure will prevent spores from circulating and will not encourage the growth potentially created by the tightly sealed microclimate of a plastic bag. Alternatively, move the affected material (after it has been placed in a sealed container – DO NOT LEAVE THE MATERIAL IN THE SEALED CONTAINER) to a clean area with relative humidity below 45%, separate from the rest of the collection, and allow the material to dry. If immediate drying is not possible, or if many objects are wet, contact Library Conservation and Collection Care Service in order to use their freezer; later they can be thawed, dried, and cleaned in small batches. Material may also be freeze-dried and then cleaned. When dry, the items should be cleaned and stored under suitable environmental conditions. The storage environment is critical since even after cleaning, fungal residue will be present.

A WOMAN who claimed dampness in her council house caused her to develop pneumonia has been awarded €25,000 in damages.

Mother-of-seven Bea O'Neill of Ballinamanagh, Kilcummin, Co Kerry, had been seeking €38,000 in damages from Kerry County Council for personal injuries and damage caused to her furniture. Yesterday, at Tralee Circuit Court, Judge Thomas E O'Donnell found in her favour and awarded €25,000 and costs. Judge O'Donnell said he felt the conditions of the house were a contributory factor but not the main factor in her illness that resulted in Ms O'Neill being hospitalised for separate bouts of pneumonia in 2006 and 2007. During the course of the hearing, the court was told Ms O'Neill was a smoker. The council claimed that Ms O'Neill's actions and poor household management caused the dampness and mould. Speaking to the Irish Independent following the ruling, Ms O'Neill said she had waited 10 years for her "day in court" and was relieved it was all over. INSULTING "To be constantly told it was my fault for not opening widows or lighting fires was so insulting that I felt if I came out with one cent it was important to go ahead with the case," she said. Ms O'Neill said she had to take out loans to replace furniture that wa ruined. Ms O'Neill moved into the house, also at Ballinamanagh, Kilcummin, in August 2001 with two of her children who were aged three and two at the time. She was also pregnant. She said she first noticed the condensation that winter but it wasn't until the following winter that she noticed mould and mildew forming on the walls. Dr David Murphy of Cork University Hospital told the court that mould in a house would be a "significant contributor", combined with smoking, to the development of pneumonia and borderline kidney failure. Ms O'Neill said despite her complaints to the council that were backed up by letters from her GP, it wasn't until 2010 that she was rehoused. Consultant engineer William O'Keeffe told the court he didn't consider the house "fit for human habitation" and that Ms O'Neill should have been rehoused "as a priority". Kerry County Council said it would be appealing the matter because all tenants had a responsibility to maintain their house in good condition. Irish Independent

Health Risks of Black Mold from Flood Damage

Black mold is associated with a large number of medical and healthissues, especially in children, older individuals and anyone with a compromised immune system. Black mold is a fungus that grows anywhere dark and damp. Once it reaches a certain stage, it casts off spores which can be inhaled, eaten, or even absorbed directly through the skin. It is for this reason that many houses that have flood damage are condemned and made unlivable by the government until the mold can be removed. The major health effects of black mold generally result from fluid buildup in the lungs that leads to pneumonia. Pneumonia is an inflammation or infection in the lungs that causes the alveoli, or small sacs, to become filled with fluids, usually pus. When black mold spores get into the lungs through inhalation, the body mounts an immune response, and part of that response involves diluting the spores with water. This is what leads to the formation of the pus that fills the alveoli and causes the pneumonia. Another very common health problem associate with black mold is with the upper respiratory tract. Black mold, because of its structure, sticks to the mucus membrane of the nose and sinus cavities and causes an immune response there. The symptoms when this happens will mimic the common cold, but will progressively get worse unless the individual is removed from the environment. Over weeks, these will progress and will lead to symptoms like dehydration, headaches and nausea along with the URI symptoms of a runny nose and cough. Black mold has also been found to be extremely dangerous to babies, and produces a condition called Infant Pulmonary Hemorrhaging. In this condition, the lining of the lungs becomes so irritated by the presence of black mold, that ulcers develop that bleed into the lungs. This results in conditions similar to pneumonia and ultimately leads to the death of the child. Health problems related to black mold are easily prevented by making sure your home and workspace is free from the environment necessary to breed black mold. This includes making sure your basement is well ventilated and dry. It may be necessary to place a dehumidifier in the basement to make sure any excess groundwater does not feed the mold. It is also necessary to make sure any rugs and carpeting are completely dry before being placed back in the house, this includes after a water accident or flood, or with normal washing. In places like the basement where there is continuous dampness, it is best not to install carpet, but instead use a floor covering that does not absorb the moisture. Source: http://voices.yahoo.com

Mould Inspection

Do you think mold might be growing somewhere in your home? If so then you should have a mold inspection performed. Goals of a Mold Inspection There are two goals of a mold inspection. The first is to find if and where mold is growing in your home. The second is to find the water problem which caused the mold to grow in the first place.

Why You Should Have A Mold Inspection The obvious reason to have a mold inspection is if you think you have a mold problem in your home. Even if you already know where mold is growing in your home it is a good idea to perform a mold inspection since visible mold growth often means there is more mold growing somewhere out of view. Signs of Mold Some common reasons to suspect you could have a mold problem include: You are suffering allergic symptoms You notice a mold smell You have had a water problem, for example: flooding, leaking pipes or a leaking roof You can look here for more signs of mold problems. Hiring a Professional Mold Inspector It's always best to hire a professional mold inspector to do the mold inspection for you. Thanks to mold inspectors' experience and their knowledge of spots where mold most often hides, you can be sure that if there's any mold in your home that they will find it. Mold inspectors also use special equipment like moisture meters and fiber optics. This allows them to find hot spots where mold is most likely growing and look into hidden areas such as behind walls. This way they can find any and all hidden mold while barely disturbing your home. History of Water Problems It's important to think of recent water problems you've had in your home when it comes to preparing for a mold inspection. If you hire a professional mold inspector it's a good idea to let them know about any leaks, floods or any other moisture problems you've had in your home. If you are performing the mold inspection yourself then knowing about places which had water problems in the past will give you clues about where the mold is most likely growing. There might have even been water problems in the past which you never found out about. By looking for signs of moisture like warped surfaces, water stains or peeling paint you might find recent water problems which have lead to mold growth. You should also identify areas which have the potential for water problems such as where pipes run, air conditioner leaks, possible leaking roofs or where water collects after flooding. Finding Mold During the Inspection If you decide to do the mold inspection yourself then you need to thoroughly search for mold in every room of your house including the attic and the basement. Special attention should be paid to areas around water sources such as near the shower or bathtub, sinks or pipes. You should check especially carefully the areas which have had any history of moisture problems in the past. During your search for mold if you do find any water leaks this can then lead you to where mold is growing. Some common places where mold often grows is on substances high in cellulose such as drywall, under carpets, in insulation or in ventilation ducts. Visit Where Mold Grows for more help with finding mold and for more places where mold often grows. Hidden Mold If you cannot see mold in a room it doesn't mean there is none there. Mold can often grow hidden from view behind walls, above ceilings, under floors or in air conditioning ducts. If you find small spots of mold on a surface it could mean there is a much larger mold colony growing hidden away on the other side. Besides using your eyes pay attention to any odors. The smell of a mold colony can help you to narrow down where mold is hiding. Any health issues you notice which occur when you're in certain areas of your home can also alert you to the presence of nearby mold. Symptoms such as sneezing and sore or water eyes can be tell tale signs of mold growth nearby. Don't Disturb Mold If you do find large areas of mold during the inspection be careful not to disturb it if possible as this can spread spores or even mycotoxins throughout your home. Large mold colonies should only be disturbed once you have set up the proper containment during remediation. Recognizing Mold Sometimes you might find what you think is mold but what might actually be dark soot or just dirty spots. Look closely to be sure that what you have found is mold, disturbing it minimally if you need to examine it physically. If you are unsure you can always use a mold test kit to verify. Testing can also be helpful if for some reason you want to identify the species of mold you have found in your home. Finding Water Problems The second stage of mold inspection after finding mold growth is to find the water problem that caused the mold in the first place. There is no point going to the trouble of finding and removing mold in your home if the water problem that caused it is not fixed and then soon causes the mold to return. You should search your home for any water leaks or evidence of leaks. Besides stopping the leak or other water source you will need to take action to make sure it doesn't reoccur in the future. Once you have found the cause of the mold in your home you will first need to fix it and then clean up any remaining moisture. After Finding Mold After you have found the mold in your home you need to determine the size and extent of the mold colony before you can begin to remove it. If the mold looks like it might be toxic you should think about having it tested to determine its species so you'll know whether you can remove it yourself or whether you should hire a professional. In either case you should not disturb any large mold colonies you find yet since proper containment should be set up before mold removal to prevent spores spreading throughout your home. Mold Testing Mold testing can either rule out the presence of mold or help track down its location if it's hidden. If mold was found and you decide you want to test the mold to find out its species, eg in case it's toxic or to confirm it really is mold, then testing will also tell you what you want to know. You can visit Mold Testing if you want to find out more information about testing for mold in your home. Mold Remediation Once you have found all the mold in your home you're ready to move on to thinking about the mold removal and remediation process. See the Mold Removal page for a guide to removing and remediating mold in your home. After you have removed and remediated a mold problem you might want to perform the mold inspection process again to make sure that the mold clean up was successful. Source:www.blackmold.awardspace.com

Mould-infested flat forces family to flee every night over health fears

Mould-infested flat forces family to flee every night over health fears By Jennifer Hough Tuesday, March 29, 2011 A WOMAN and her three young children are being forced to leave their mould-infested home by night and sleep elsewhere due to health concerns linked to the condition of the flat. Slattery, 30, who lives in Dolphin House, Rialto, spoke to the Irish Examiner about the constant worry she lives with as her flat is covered in black mould which she feels could be damaging her children’s health. She and her three children, aged eight, five, and 10 months, have taken to sleeping in one bedroom at her mother’s house nearby. Ms Slattery is one of many residents of Dolphin’s House estate who are campaigning for better living conditions. They say that the daily health risk is a blatant violation of their right to adequate housing and called for a commitment from the Department of Environment to fund its regeneration. A study, published yesterday at a human rights monitoring hearing in Rialto, showed that 45% of adults and 42% of children living in the Dublin estate have trouble breathing easily and more than 90% are worried about their health. Residents reported diarrhoea and skin rashes, with some saying depression is also a consequence of living in a cold, damp smelly flat. "I have had the flat for eight and a half years now, and I’d say I was in it six months it when the problem first began. There was very bad dampness with white fluffy mould growing through the wall. The council came and treated it and re-wallpapered." Ms Slattery maintains, however, that in the past two years, it has "come back with a vengeance," but the council have not been back. "There is black mould around the windows even though they are PVC. "The walls in the bedroom are black, the wallpaper is peeling off, even my mattress is black and green and mouldy." Because of this, she says she doesn’t feel safe sleeping at the flat. "We stay in my sister’s room. She is away at college but she is back next month so I don’t know what we will do then. You are breathing it in all time, the kids were sick at the weekend — they were vomiting — I don’t know if it’s related but I am afraid it might be." As well as the mould, there is a rusty, leaking, waste pipe in the bathroom. "Other people’s waste runs down the pipe, it is just a trickle, but you can smell it. The pipe needs to be replaced, I have been waiting two years for that to happen. It is very stressful, my five-year-old asked me is she sick because of the mould. I was reared in these flats, and I just want somewhere safe and healthy to bring up my kids." A spokesperson for Dublin City Council said it is working with the residents to resolve maintenance issues. He said there is a monthly meeting between council representatives and the local maintenance group at which such matters and other issues are discussed. A spokesman for the Department of Environment said it has yet to receive a proposal from Dublin City Council with regards to Dolphin House. This story appeared in the printed version of the Irish Examiner Tuesday, March 29, 2011

Expensive solution for mould removal!

The cheapest solution for mould on walls etc is Mould Stop. A powerful fungicidal anti mould additive developed for extreme Tropical conditions that can be mixed into any paint or even grout and it works by creating an environment on the wall etc which mould spores cannot tolerate and accordingly ‘decide not move in’! Warmcoat Advanced paint €74.97

Health Risks

Health Risks: Moulds present a health hazard to humans because they release spores. These spores can cause allergic reactions and other respiratory problems especially in asthmatics. Eye irritation is also common. Some moulds produce mycotoxins which can result in severe neurological problems and even death after prolonged and untreated exposure. Symptoms of a mould allergy include watery, itchy eyes, chronic coughing , headaches or migraines, a difficulty breathing, inexplicable rashes, fatigue, sinus problems, nasal blockage and frequent sneezing. Anti-Mould Paint: This is a simple preventative method that involves using a specially formulated paint to deter the growth of moulds and mildews. This type of paint reduces condensation, insulating the wall and raising the temperature of the surface to reduce the amount of moisture and therefore mould in the home. This paint can be used for stippled or plain surfaces and greatly reduces the chance of mould and mildew growth. Remedial Steps: For smaller infestations, some less extreme measures may be taken. Exposing the mould growth to sunlight could reduce the problem. Similarly, improving ventilation in the room with mould can curb the mould's growth. Dehumidifiers and household cleansers may also have a positive effect on controlling the growth of the mould. However, some infestations require a more radical approach and professional removal. Mould Removal Dublin: Only trained professionals should attempt mould removal as close exposure to the spores can be dangerous. There are several methods for the successful removal of moulds in the home. • Dry ice blasting ' this method can be used on surfaces such as wood and cement. Soda and Media blasting are also efficient mould removal methods and are preferred to encapsulation which simply covers up the mould. • Vacuum - Wet vacuum cleaners can remove moulds from floors, carpets and other hard surfaces. This method should only be used if the mould is sufficiently wet otherwise spores may be exhausted into the indoor environment. • Damp wipe ' this form of Dublin mould treatment uses wiping or scrubbing moulds from non-porous surfaces with astringents. Fungicides should then be applied to prevent regrowth. • HEPA vacuum ' the high efficiency particulate air vacuum cleaners are used for clean-up sessions after others methods of removal have been used. All collected dust and debris should be stored in impervious bags to prevent unwanted release of spores. Tired of living with ugly and smelly mould colonies in your home? Concerned about the health of you and your loved ones? It might be time to consider professional Dublin mould removal. Need the help of specialists but concerned about the costs? We can help you find the best quality, affordable mould solutions at a price to suit your budget. Get a free, no-obligation quote from us today and wave goodbye to hazardous mould colonies.

Mucormycosis and Natural Disasters

Mucormycosis and Natural Disasters By Dr. Michelle Seidl, EMLab P&K Senior Analyst In 2012, Hurricane Sandy devastated parts of the Eastern seaboard and many areas of the Northern Caribbean. In 2011, a massive tornado wreaked havoc on Joplin, MO and nearby areas. In Southeast Asia in 2005, a tsunami left a destructive wake behind. These and other natural disasters are hotbeds for the occurrence and spread of various diseases. One example of an uncommon fungal disease that has been associated with various natural disasters is mucormycosis, also known more broadly as zygomycosis. Though the loss of life from this disease is very low when compared to the total loss of life caused by such horrific events, understanding the potential for this kind of infection could potentially save lives. Several people in Joplin, MO who were injured by the tornado developed a rare and potentially deadly fungal infection caused by a zygomycetous fungus. A recap of the May 22, 2011 event in relation to mucormycosis can be found on the CDC website. The physical and psychological damages the city of Joplin sustained were devastating. On June 3, 2011, a local physician notified the county and state health officials of two patients hospitalized with tornado-related injuries having suspected necrotizing (death of a specific area of tissue) fungal soft-tissue wound infections caused by a zygomycetous (mucoralean) fungus ((MMWR) July 29, 2011/60(29); 992.). The CDC and Missouri State Health Department immediately began active surveillance for such infections at hospitals and laboratories that were serving patients injured in the tornado. Within a week, eight patients with necrotizing fungal soft-tissue wound infections caused by mucoralean fungi were identified. About a month later, a total of 18 suspected cases of cutaneous (affecting the skin) mucormycosis had been identified, 13 of which were confirmed. A confirmed case here was defined as necrotizing soft tissue infection requiring antifungal treatment or surgical removal of the dead tissue, onset of the illness after May 22, 2011 and a positive fungal culture or histopathology and genetic sequencing consistent with a mucoralean fungus. No additional cases in that specific geographic area were reported after June 17, 2011. Of the 13 confirmed cases, 7 were female, 6 were male, all were white, and the age range was 13-76. Injuries sustained during the tornado included lacerations, fractures and blunt trauma. Two of the 13 patients had diabetes, none were immunocompromised, 10 required admission to an intensive care unit and 5 died. Specimens from all 13 patients yielded the mucoralean fungus: Apophysomyces trapeziformis.1 This fungus belongs to the fungal phylum Zygomycota, class Zygomycetes, subdivision Mucormycotina, order Mucorales, and classified in the family Mucoraceae. Since this tornado struck in late May during the growing season, spores could have been stirred up by the tornado, then dispersed to the victims through wounds from injuries or by ingestion or inhalation. All of those diagnosed with mucormycosis did have multiple injuries and secondary wound infections (Williams 2011). Following the Asian tsunami in 2004, a 56-year-old male survivor was diagnosed with an infection caused by another fungus in the same genus: Apophysomyces elegans.2 The survivor escaped broken bones but sustained traumatic wounds (Davis 2005). Despite cleaning and bandaging his wounds, he became feverish within 5 days. He was given broad spectrum antibiotics, the dead tissue cut away, and despite vigilant wound care, the fever remained and his condition worsened (Andreson, et al. 2005). This prompted a warning by doctors that survivors were at risk for this kind of fungal infection. In 1985, during one of the largest volcanic eruptions in recorded history, over 23,000 people died and 4,500 were seriously wounded. Of those wounded, 8 people were diagnosed with mucormycosis and 6 died. At the time, a plea was made for an early diagnosis, utilizing tissue sampling and microbiological studies, so that prompt and radical treatment could be instituted. This is especially pertinent in situations of natural disasters resulting in massive numbers of casualties and seriously injured survivors (Patiño, et al. 1991). Zygomycosis vs. Mucormycosis Zygomycosis is the most broadly encompassing term for a variety of diseases caused by fungi in the class Zygomycetes. Zygomycosis was originally described as a convenient and inclusive term for 2 clinically different diseases: mucormycosis caused by members of the order Mucorales and entomophthoramycosis caused by members of the order Entomophthorales (Kwong-Chun 2012). These two fungal orders comprise distinct lineages within the Zygomycetes (Hibbett et al. 2007; White et al. 2006). Most zygomycete infection cases are classified as mucormycosis. Of the rare clinical isolates identified as belonging to the Entomophthorales, most are caused by the genera Conidiobolus and Basidiobolus (Sugar 2007; Ribes, et al. 2000). Unfortunately, older literature describing cases of zygomycosis prior to molecular sequencing frequently did not identify the pathogen due to difficulty in culturing and due to lack of expertise needed to identify species using micromorphological methods (Iwen, et al. 2011). The general consensus is to have a combined approach which adopts both morphologic and molecular methods for species identification. In this article, and by definition, the term "mucormycosis" excludes members of the order Entomophthorales. In the laboratory, mucoralean fungi (e.g. the genus Mucor, see Figure 1), grow well on most standard fungal culture media such as Sabouraud dextrose agar. For a majority of the species associated with human disease, the growth is usually rapid with mycelial elements covering the entire plate within 2 to 3 days of incubation at 30°C. Unfortunately, the recovery of mucoralean fungi from tissue has been described as difficult, with negative results reported despite histological evidence of the presence of a zygomycete. Mucor spores and sporangia Figure 1: Mucor spores and sporangia. Copyright © 2013 EMLab P&K One reason for this inability to recover the fungus appears to be partly related to aggressive processing of the specimen that may damage the organism. A review by Roden, et al. (2005), described a clear increase in culture positivity over time with 71% of all cases since 2000 diagnosed on the basis of culture results. This improvement was suggested to be due to better training, a greater understanding of specimen processing, improved culture techniques, and increased access to sophisticated reference laboratories. The vegetative mycelium of all species in the Mucorales is composed of wide diameter, predominantly aseptate (nonseptate), colorless hyphae. The general growth characteristics useful for differentiation of members of this group include colony morphology, the presence of sporangiophores bearing multi-spored sporangia, and the presence or absence of rhizoids. Other methods helpful in identification include maximum temperature at which the isolate will grow and the ability of the organism to assimilate ethanol. Zygospore (sexual spore) formation would be another tool to use but is not always reproducible and can prove difficult. Mating studies require the maintenance of a library of tester strains and are often unrealistic. Fungal Genera Involved The most common genus involved in mucormycosis is Rhizopus (Fig. 2). Following is a list of genera that have been associated with this type of human infection: Rhizopus Mucor Rhizomucor Absidia (Lichtheimia) Apophysomyces Saksenaea Cunninghamella Cokeromyces Syncephalastrum Rhizopus spores and sporangium Figure 2: Rhizopus spores and sporangium. Copyright © 2013 EMLab P&K The Disease Mucormycosis is a very aggressive and severe infection, but is also very rare (Williams 2011). Organs and areas commonly affected include the sinuses, eyes, skin, brain and lungs. It may also affect the gastrointestinal tract, the skeletal system, the myocardium and endocardium, as well as the kidney (Walsh et al. 2012). It can also occur as a disseminated infection and play a role in allergic fungal sinusitis. The reference to cutaneous mucormycosis, translates to a disease caused by a member of the Mucorales and affecting the skin. Mucormycosis occurs primarily in people with immune disorders. It can occur, but is generally rare, in immunocompetent hosts. It is considered an opportunistic infection and often affects individuals with pre-existing conditions. Factors or conditions that are known to put humans at risk include: AIDS, diabetes mellitus (usually poorly controlled), lymphoma or leukemia, hematologic malignancy, neutropenia, organ transplants, sustained immunosuppressive therapy, long-term steroid use, metabolic acidosis, iron chelation therapy, broad-spectrum antibiotic use, injection drug use, protein or severe malnutrition and breakdown of the skin barrier such as trauma, surgical wounds, needle punctures or burns. The main risk factors for infection following a natural disaster are spore inhalation, spore ingestion and penetration through injuries that break the skin. Ibrahim et al. (2012), found that patients with elevated serum levels of available iron are susceptible to mucormycosis. These infections are highly angioinvasive (tendency to invade the walls of blood vessels), as the organism acquires iron from the host. This typically follows traumatic implantation or inhalation of the fungus. The disease is most common in the tropics, with cases reported from India, Australia, USA, Sri Lanka, Thailand, Central America and South America (Alvarez et al. 2010). Symptoms depend on the condition of the individual and the extent and location of the infection. If not diagnosed early, mucormycosis has an extremely high mortality rate (25% to 80%, averaging 40%). If properly diagnosed, the infection can be treated with antifungal agents (Davis 2005). At the time of this writing, according to the literature and the Mycotic Diseases Branch of the CDC, zero mucormycosis cases were reported as a result of Hurricane Sandy. Risk assessment is essential in post-disaster situations and the rapid implementation of control measures through re-establishment and improvement of primary healthcare delivery should be given high priority, especially in the absence of pre-disaster surveillance data (Kouadio, et al. 2012). As to whether or not we can say mucormycosis is definitively correlated with natural disasters, the jury is still out and more data will need to be gathered. For now, awareness is critical for prevention and treatment. If the disease is on the "radar screen" of attending physicians and workers following a disaster, the earlier clinical cases can be identified and treated, thereby avoiding this potentially deadly fungal infection from going undiagnosed. 1 Authors of this species: E. Álvarez, A. Stchigel, J. Cano, D. A. Sutton & J. Guarro. 2 Authors of this species: P.C. Misra, K.J. Srivastava & K. Lata. References: Alvarez, E, AM Stchigel, J Cano, DA Sutton, AW Fothergill, et al. 2010. 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DOI:10.1309/LMJ8Z0QPJ8BFVMZF Kouadio, IK, S Aljunid, T Kamigaki, K Hammad & H Oshitani. 2012. Infectious diseases following natural disasters: prevention and control measures. Expert Rev. Anti Infect. Ther 10(1): 95-104. Kwong-Chun, Kyung J. 2012. Taxonomy of Fungi Causing Mucormycosis and Entomophthoramycosis (Zygomycosis) and Nomenclature of the Disease: Molecular Mycologic Perspectives. Oxford University Press (Infectious Diseases Society of America). Clin Infect Dis. 54 (suppl 1): S8-S15. doi: 10.1093/cid/cir864 Patiño JF, Castro D, Valencia A, Morales P. 1991. Necrotizing soft tissue lesions after a volcanic cataclysm. World J Surg. Mar-Apr;15(2):240-7. Ribes, JA, CL Vanover-Sams & DJ Baker. 2000. Zygomycetes in human disease. Clin. Microbiol. Rev. 13(2): 236-301. Roden MM, Zaoutis TE, Buchanan WL, et al. 2005. Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin Infect Dis. 41L634-653. Sugar, Alan M. 2007. 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