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This is pear rust (Gymnosporangium sabinae). It is fairly widespread in the northern hemisphere: It is a fungal infection and affects pear trees from junipers. Pruning the affected nearby junipers can help control its spread.


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This page seems to indicate that it adheres to the epithelium of different internal organs. They write: The sporozoites are released and parasitize epithelial cells (b, c) of the gastrointestinal tract or other tissues such as the respiratory tract. Here is the figure from that page:


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