The Centers for Disease Control and Prevention said 221 students developed the illness, which can cause fever, cough, shortness of breath, chest pain and headaches. Histoplasmosis can be treated with an antifungal medication, though 10 students in six states required hospitalization.
Preliminary laboratory test results indicate that the illness was probably histoplasmosis, an infection caused by a fungus present in the soil. Researchers said construction near an Acapulco hotel might have disturbed contaminated soil.
"It's a matter of being exposed to the environment and the soil being disturbed where the fungus may be," said Dr. Maria Cano, an epidemiologist in the CDC's National Center for Infectious Diseases.
The first illnesses were detected at Villanova University in Pennsylvania, where 29 students became ill about two weeks after returning home. Students who became sick had stayed at or visited Calinda Beach Hotel in Acapulco.
"Apparently, there was a parking garage being built next door, and when the bulldozers picked up the soil, the students happened to inhale some of the spores while they were sitting by the pool or relaxing," said Dr. Richard Pacropis of Villanova Health Center.
The CDC recommended that students who have traveled to Acapulco since March 1 should seek medical attention if they develop any symptoms of histoplasmosis.
"We've been involved in many histoplasmosis outbreaks, but not to this extent. This is a multi-state outbreak. This is unique in that regard," Cano said.
The illness, which is not contagious between people, has been reported in Arizona, Connecticut, Delaware, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, North Dakota, Ohio, Pennsylvania, Rhode Island, Texas, Wisconsin and the District of Columbia.
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