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Volume 32, Number 3—March 2026

CME ACTIVITY - Research

Blastomyces Urine Antigen Testing for Active Case Identification During a Blastomycosis Outbreak

Allyson W. O’Connor1, Ian Hennessee1, Perri C. Callaway, Marcia L. Stanton, Xiaoming Liang, Ju-Hyeong Park, Ryan LeBouf, Rachel L. Bailey, Rebecca Reik, Mary Grace Stobierski, Michael Snyder, Robert Yin, Mitsuru TodaComments to Author , Jean Cox-Ganser, and Stella E. Hines
Author affiliation: Centers for Disease Control and Prevention, Morgantown, West Virginia, USA (A.W. O'Connor, P.C. Callaway, M.L. Stanton, X. Liang, J.-H. Park, R. LeBouf, R.L. Bailey, J. Cox-Ganser, S.E. Hines); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Hennessee, P.C. Callaway, M. Toda); Michigan Department of Health and Human Services, Lansing, Michigan, USA (R. Reik, M.G. Stobierski); Public Health Delta & Menominee Counties, Escanaba, Michigan, USA (M. Snyder, R. Yin)

Main Article

Table 3

Clinical factors by UAT levels for employees with positive tests from the medical survey conducted in a study of Blastomyces urine antigen testing for active case identification during a blastomycosis outbreak, United States*

Clinical factor Positive UAT result, n = 52
Below LLOQ, n = 17 Within or above quantifiable range, n = 35
No. symptoms potentially related to blastomycosis
0 3 (18) 2 (6)
1 3 (18) 2 (6)
>2
 11 (65)
 31 (89)
No. medical findings potentially related to blastomycosis
0 10 (59) 18 (51)
>1
 7 (41)
 17 (49)
Days from symptom onset to test, median (IQR)†
 49 (37–70)
 45 (23–70)
Potentially immunocompromised‡
Yes 2 (12) 5 (14)
No
 15 (88)
 30 (86)
Had a recent blastomycosis diagnosis
Yes 8 (47) 19 (54)
No
 9 (53)
 16 (46)
Pneumonia diagnosis
Yes 2 (12) 6 (17)
No
 15 (88)
 29 (83)
Hospitalized for blastomycosis†
Yes 0 8 (28)
No
 17 (100)
 21 (72)
Antifungal drug initiated†
Yes 8 (100) 17 (94)
No
 0
 1 (6)
Days from antifungal drug initiation to antigen test, median (IQR)† 25 (15–38) 31 (13–43)

*Values are no. (%) except as indicated. Numbers might not reach column total because of missing responses. LLOQ was 0.2 ng/mL, quantifiable range was 0.2–14.7 ng/mL. UAT, urine antigen test; LLOQ, lower limit of quantification. †Data were only collected for employees with a recent diagnosis of blastomycosis during the outbreak (n = 71) and thus not available for all employees. ‡Potentially immunocompromised was defined as reporting diabetes, an autoimmune disease, taking immunosuppressive medication, or an organ transplant.

Main Article

1These first authors contributed equally to this article.

Page created: February 13, 2026
Page updated: March 20, 2026
Page reviewed: March 20, 2026
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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