BETWEEN APRIL 23 and June 30, 1988, 84 cases of cutaneous sporotrichosis occurred in persons who handled conifer seedlings packed in Pennsylvania with sphagnum moss that had been harvested in Wisconsin. An outbreak-related case was defined as physician-diagnosed sporotrichosis in a person who had handled seedlings and/or moss. Confirmed cases occurred in 14 states: New York, 29 cases; Illinois, 23; Pennsylvania, 12; Ohio, five; Wisconsin, three; Connecticut, North Carolina, and Vermont, two each; and Indiana, Iowa, Massachusetts, Michigan, New Hampshire, and Virginia, one each. Each of these persons handled seedlings from April 4 to May 16; symptoms developed between April 23 and June 30.
Thirty-one (37%) cases occurred in state forestry workers and garden club members who participated in annual tree distributions in which seedlings were separated from one another, repacked in moss, and distributed to area residents. In addition, 12 patients had received seedlings through these distributions, 38 had