An extremely poor cluster of zip codes, Eastern Cleveland (Ohio), saw, in January 1993, an unusually high frequency of Pulmonary Hemorrhage with respiratory distress in infants below 6 months.
In this area 82.2% of the population is African American. 48.2% of families were below the poverty level.
37 cases were to be described in this vicinity between 1993 and 1998. Twelve infants died.
For those who survived initially 60% experienced recurrent hemorrhage upon returning to their homes.
These homes had a high prevalence of water damage. The area is a drainage plain where basements are frequently flooded by rainstorms.
Stachybotrys was found in 20 of 23 investigated homes.

the sort of house incriminated, 17 years later
Over the years, opinions became somewhat controversial as to how to consider these events. Some authors  even published titles such as " Toxic mold: phantom risk versus science". Others argued that airborne mycotoxins in daily life in the indoor environment are below even the "concentration of no toxicologic concern", not insisting on the fact that, for the Cleveland cases in the 90's, nobody had checked if there were or not any mycotoxins around.
The fact remains that there was a cluster of cases of infantile Pulmonary Hemorrhage. The published hospital data shows that exploration of non fungic aetiologies described in text books until then was very seriously performed, and that none were found.
Cleveland, Ohio
Targeting the enigma
Since this dramaric episode, scientists from the US and many other countries have been grappling with this "Public Health Enigma", name coined by one of the key specialists of the field, Pr James J. Pestka.
Like in detective stories, things were complex, and three suspects were slowly identified. Birgitte Andersen, Kristian F. Nielsen and Ulf Thrane from Denmark; Tim Szaro and John W. Taylor from U; of California, Berkeley; Bruce B. Jarvis U. of Maryland, College Park all played an important role in this unraveling.
The three guilty fungi
In the Stachybotrys gender, two species are involved : S. chartarum and S. chlorohalonata. S. chartarum itself presents two chemotypes : S. chartarum A, and S. chartarum S
These three types produce a different assortment of trichothecene mycotoxins.
- Trichodermin and trichodermol are precursors and/or metabolites of Roridins and Satratoxins.
- Dolabellanes are precursors and/or metabolites of Atranones
The fungi isolaterd in Eastern Cleveland were S. chartarum A. They produce Atranones, that can induce pulmonary inflammation.This is clearly demonstrated by T.G. Rand and his group, click to reach our page
Satratoxins, from S. chartarum S. can induce neurotoxicity, which for many years James J. Pestka and coworkers have been exploring.