Emergence of Cryptococcus gattii—Pacific Northwest, 2004–2010
Bibliographic record
Abstract
Cryptococcus is a genus of fungi, of which two species, Cryptococcus neoformans and Cryptococcus gattii, cause nearly all human and animal cryptococcal infections. Whereas C. neoformans primarily affects persons infected with human immunodefi ciency virus (HIV) worldwide, C. gattii primarily affects HIV-uninfected persons in tropical and subtropical regions (1). In December 2004, a case of human C. gattii infection was reported in Oregon, associated with an outbreak on Vancouver Island and in mainland British Columbia, Canada (2). A second C. gattii case was reported in Oregon in 2005, and 12 more cases were reported in 2006 and 2007. In 2008, in response to the emergence of C. gattii in the United States, CDC, state and local public health authorities, and the British Columbia Centre for Disease Control (BCCDC) formed the Cryptococcus gattii Public Health Working Group (1). States began collecting epidemiologic information on patients and sending isolates to CDC. By July 2010, a total of 60 human cases had been reported to CDC from four states (California, Idaho, Oregon, and Washington) in the Pacifi c Northwest. Among 52 patients for whom travel history was known, 46 (88%) said they had not traveled to British Columbia or any other C. gattii-endemic areas, suggesting they acquired the infection locally. Among 45 patients with known outcomes, nine (20%) died because of C. gattii infection, and six (13%) died with C. gattii infection. Physicians should consider C. gattii as a possible etiology of a cryptococcal infection among persons living in or traveling to the Pacifi c Northwest or traveling to other C. gattii-endemic areas. Multilocus sequence typing subcategorizes C. gattii into four genotypes: VGI, VGII, VGIII, and VGIV. Further genetic analysis divides the VGII genotype into three subtypes: VGIIa, VGIIb, and VGIIc (3). Although VGII is the genotype most commonly associated with the outbreak in the United States and British Columbia, it is uncommon in other C. gattii-endemic parts of the world, where VGI is isolated most frequently (3). During 1999, C. gattii began appearing in animals and humans on Vancouver Island and, beginning in 2004,
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".