17 STRUCK BY

HISTOPLASMOSIS

Rick Glascock

It isn’t unusual for me to be staring into the dark, cavernous opening of a person’s mouth, recently dropped in astonishment, as I recount my few experiences with caving in Mexico to my family and friends back in the United States. After all, hadn’t I come to Mexico to play in a symphony orchestra? I know that there must be a number of, spelunkers in the United States, but in my circle I’ve become the resident caving expert because of the couple of trips I took with ZOTZ the end of last year and as such have come to expect a full gambit of reactions, from fascination to humor, pity and outright dismay, to this somewhat offbeat avocation.

It was no surprise then, that the rancor intensified upon telling the folks back home that not only had Marshall and I been crawling through the bowels of Jalisco, but that we had, at the same time, discovered - along with Nacho and I4 members of CEO (Western Explorer’s Corps) - one of the few caves providing suitable conditions for the growth and transmission of histoplasmosis, a fungus that thrives on the guano of bats and. apparently, also in the fungus of humans.

JAMMING IN THE CAVE

This particular cave located only an hour from Guadalajara, was quite small in comparison to the few others we had visited in the past. Entered from a small depression in the ground, the initial short passage opens into a cavern barely tall enough to stand in at the apex and quite crowded with the 17 of us all trying to view the numerous bats that were hanging along the lower edges of the room. There was the unmistakable, earthy stench of Bat guano mixed with a musty odor from the packed dirt floor underneath.

The group was ill prepared for what was to occur. Neither Marshall nor I, nor most of the rest of the group had any type of facemask. The four or five who did were using standard cloth surgical masks. The rest of us resorted to tying bandanas around our faces or pulling our shirts up over our mouths. I guess for most of us, the possibility of contracting histoplasmosis (something I had been cautioned about) didn’t seem to be a serious threat.

A SUSPICIOUS FLU

Well, reality has a way of crashing on you, as It did for us about two weeks later when Marshall, who was by then back in Boston for vacation, complained to me over the phone of the “flu” that had plagued him for the past week: a high fever, exhaustion and respiratory congestion, “coincidentally” the same symptoms I had been fighting off all week back in Guadalajara!

“Suspicious.” You Say. Well, not half as suspicious as finding out the next morning that the entire expedition was suffering the same malady. At that point it was obvious to everyone that this was no longer a coincidence. Each one of us was running some grade of fever (both Marshall and I hit 140º at times) and exhibited respiratory congestion. On this point I faired better than others who had to contend with a persistent, hacking cough.

The most amazing aspect of this disease was the predictability of the gestation period. After comparing notes, it turned out that everyone first noticed the fever within one or two days of the others, beginning 11 days after entering the cave. A group X-ray confirmed that everyone had foreign objects in the form of spotting, on their lungs, indicating some type of fungal infection.

EAT, SLEEP AND DO NOTHING

The following week, the rest of the group and I - affectionately calling ourselves Club Histo - spent many morning hours together at the Centro Médico complex waiting for doctors (most of whom I couldn’t understand) to examine us and to give us an advisable course of treatment. Out of this and consultations whit doctors in the U.S. - myself in Los Angeles and Marshall in Boston -we learned that the best course of action was to rest, eat well and wait.

Well, sure enough, after three weeks the fever had subsided and I was well on the road to recovery, as was Marshall and, happily, the rest of the group still in Mexico.

Will I go caving again? That’s up in the air right now. I wish that out of this experience I could provide advice for other cavers about identifying caves with Histoplasmosis, but, alas, I’m afraid it’s still a lot of guesswork. Some type of quality filter mask system as no doubt a step in the right direction. I can, however, tell those who wish to explore the depths of Jalisco, which cave not to enter! As for me, I’ll be heading up, exploring the aboveground attractions of the state for the time being.

(The cave is located in a part of Jalisco previously thought to be completely free of the Histo fungus. this unfortunate incident of 100% mass infection might possibly merit a place in the Guiness Book of Records! SUBTERRÁNEO Welcomes more information on medicines to cure Histo, practices to avoid catching it, and systems for detecting the fungus in caves. - Editor)

UNCLE RICK’S HISTOPLASMOSIS ALMANAC

DEFINITION Histoplasmosis, also called “Ohio Valley Fever” in The U.S. because of its prevalence there, is a fungus that thrives on the guano of birds and bats and whose spores can be inhaled into the human lungs where they take up residence and grow. It has a close relative, coccidioidomycosis, which is common in farm workers of California’s San Joaquín Valley and exhibits identical symptoms.

SYMPTOMS: Based on the CEO expedition, these include: A high fever beginning 10 to 11 days after the initial exposure Respiratory congestion, in many cases a persistent cough The appearances of “nodules” en the lungs as viewed through an X-ray Fatigue, lack of energy

TREATMENTS: There are three levels of treatments available:

1. The majority of doctors recommend the simple, commonsense approach for Histo victims who don’t appear to be in a life-threatening situation. That is much rest and good food Most bodies have the capability of producing antibodies to fight off the fungus. (Note, antibiotics are ineffective against fungal infection.)

2. One doctor recommended a long-term treatment (up to a year) with a medicine called Nicoral. However, several others stated that this product’s effectiveness is still questionable and that there is a possibility of side effects (gastral irritation or kidney damage)

3. For a life-threatening situation (I was assured that this as fairly uncommon) there as a very strong and very risky chemical treatment that actually poisons the body and the fungus.

UNCLE RICK’S FINAL ADVICE:

It you suspect you’ve got Histo, it goes without saying that a doctor should be consulted (not just this almanac!).

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SUBTERRANEO WEBMASTER:  Luis Rojas    ZOTZ WEBMASTER:  Chris Lloyd    COORDINATOR:  John J. Pint    ASISTENTE:  Susy Ibarra de Pint     ARTE: Jesús Moreno    TRANSLATORS:  Susy Pint, José Luis Zavala, Nani Ibarra, Claudio Chilomer, Luis Rojas    U.S. MAILING ADDRESS: ZOTZ, PMB 5-100,  1605-B Pacific Rim Ct, San Diego, CA 92154-7517   DIRECCIÓN EN MÉXICO: Zotz, Apdo 5-100, López Cotilla 1880, CP 44149, Guadalajara, Jalisco, México.    TELS:  (L. Rojas) (52-3) 675-3876,  (C. Lloyd)  (52-3) 151-0119   COPYRIGHT: 2000 by  Grupo Espeleológico ZOTZ. (Zotz = murciélago en maya / bat in Mayan)