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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.


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 spots".

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.


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