Objective: Given the geographic expansion of sporotrichosis in Brazil in the last decades and it zoonotic importance in public health, this study aimed to describe an outbreak of the disease in humans associated with the increase in feline sporotrichosis cases in the last five years. Methods: A retrospective study was performed including all human and feline sporotrichosis cases diagnosed at the Mycology Lab from Federal University of Rio Grande (FURG), and/or notified to the Zoonosis Control Center (ZCC) of Municipal Health Secretary (MHS) of Pelotas (RS, Brazil), between October 2012 and October 2017. Only proved cases, defined as those that had Sporothrix spp. growth in mycological culture of clinical samples were included. Clinic-epidemiological data of the patients were collected accessing the databases of the Mycology Lab (FaMed-FURG) and of the ZCC-SMS Pelotas, as well as by checking the Medical Records Service (SAME) of HU-FURG. Results: Across the five-years studied, a total of 101 human sporotrichosis cases were diagnosed in the South region of RS, Brazil, corresponding to an average of 20 cases per year. The number of cases reported each year was not the same, ranging from eight to 27 cases. Patients were mostly women (62.4%) and adults (81.5%) with a mean age of 40 years (ranging between 2 and 83 years). Fixed and lymphocutaneous lesions were predominant (73.3%), with impairment of hands and/or arms in 73% of the cases (n=54), followed by face (n=11) and legs (n=09). Data concerning the source of infection was available in 91 patients (90.1%), being the zoonotic transmission responsible for 93.4%, with patient narrative of scratch, bite and/or contact with sick cats. In fact, 78.8% (26/33) of these Sporothrix sp. humans isolates submitted to PCR were identified as S. brasiliensis. Regarding feline sporotrichosis, 375 cases were diagnosed in the same period in south region of RS, corresponding to about 75 cases/year. An increase of 120% in numbers of cases occurred when comparing the first with the last year studied. Almost a half of felines (56%) evaluated showed the disseminated form of the disease, and considering 153 animals in which data concerning outcome was available, 35% of them died. Regarding epidemiological data 75% of the felines were males, 63% not castrated and 95% had access to the streets, highlighting their high potential on the disease transmission and dissemination. Conclusion: The increase in feline sporotrichosis cases, associated with the human sporotrichosis outbreak described, majority of them with zoonotic transmission, shows that the epidemiological situation of the disease in South region of RS, Brazil, is extreme worrying to public health, which may take severe proportions in future years.

5 / Outbreak of zoonotic sporotrichosis in Southern Brazil