An epidemiological investigation of the first outbreak of rhinosporidiosis in Europe.

Until January 1992 rhinosporidiosis was unknown in the Balkans. The outbreak which took place at that time in northern Serbia (Yugoslavia) affected 17 people over a period of less than two years. The number of patients in this epidemic exceeded the total number of autochthonous cases of rhinosporidiosis ever recorded in Europe. The male-to-female ratio was 10:7 and, except for a middle-aged man, all patients were in the age range 6-16 years. Preponderance of ocular (12) over nasal (5) localization of the disease in this epidemic indicates that the real number of cases may be much higher. The only experience all patients had in common was that they spent their holiday preceding the onset of symptoms bathing in the same accumulation of stagnant water (the Silver Lake). A case-control study showed that the odds of being exposed to that particular environment by chance were extremely remote.