RESOLVED, that the Blinded Veterans Association,
in convention assembled in Las Vegas, Nevada, on this 1st
day of September 2001, strongly urges VA to include histoplasmosis
as a presumptive disease.
VA opposes this resolution. The most recent information from
the Institute of Medicine does not support creation of a presumption
of service connection for histoplasmosis for Vietnam veterans.
Due to the widespread distribution of histoplasmosis in the United
States, it may be difficult to determine whether histoplasmosis
infection was a result of military service in Vietnam. This is
especially true for veterans who may have lived in an endemic
area, including the Ohio or Mississippi River valley and the Appalachian
Mountains, prior and/or subsequent to military service.
AND BE IT FURTHER
RESOLVED, that BVA urges VA to recognize diseases
of the eye that manifest themselves after a period of years subsequent
to its contraction as presumptive diseases. For example, histoplasmosis
will not manifest itself as a visual impediment for several years
after infecting a person.
VA opposes this resolution.
Histoplasmosis is presumed to occur worldwide in certain river
valleys between latitudes 45 degrees north and 45 degrees south.
These river valleys may include those in the central and eastern
United States, southern Canada, Central America, the central areas
of Africa, India, Pakistan, Burma, Thailand, and other countries
of southeast Asia.
More than 99 percent of histoplasmosis infections are benign
and asymptomatic. In the United States, patients with histoplasmic
choroiditis are seen primarily in the endemic Midwest where approximately
1.6 percent of the general population may have evidence of "histo
Patients may develop "presumed" histoplasmosis choroiditis after
living outside of the endemic area for 20 years or more. The macular
form of the disease that may result in significant loss of vision
has been documented to occur 10 to 30 years after the initial
observation of disseminated areas of choroiditis.