Public Health Delta & Menominee Counties (PHDM) was notified of several atypical pneumonia infections in individuals employed at the Escanaba Billerud Paper Mill. To date, there have been fifteen cases identified that are being investigated. The symptoms for these patients began in January and February of this year. Early testing has indicated that these infections may be caused by a fungal infection called blastomycosis.
Additional testing to confirm these results may take a couple of weeks and is underway.
Blastomycosis is a fungal disease associated with a fungus that grows in moist soil and decomposing matter such as wood and leaves. People can get blastomycosis infection by breathing in fungal spores from the air. Blastomycosis does not spread from person to person or between animals and people. People who spend time near moist soil (by lakes and rivers); who participate in activities such as forestry work, hunting, and camping in wooded areas; and individuals exposed to disturbed soil may be at higher risk for getting blastomycosis.
These infections are exceedingly rare. On average over the past five years, only 26 cases have been reported for the entire State of Michigan annually. However, the Upper Peninsula (UP) of Michigan is a known risk area for blastomycosis infection.
Most people who breathe in blastomycosis spores will not get sick. Those who do get sick can develop symptoms such as cough (sometimes with blood), fever, chest pain, difficulty breathing, night sweats, fatigue, weight loss, muscle aches, and joint pain. Symptoms usually appear between 3 weeks to 3 months after exposure.
Blastomycosis can be treated with antifungal medications prescribed by a medical provider. Treatment is especially effective when administration begins as soon after symptoms as possible.
Because the fungus that causes blastomycosis occurs in the environment, it is not possible to completely avoid being exposed. People with weakened immune systems may want to consider avoiding activities that involve disrupting soil in areas where blastomycosis is found. There is currently no vaccine available to prevent blastomycosis.
The following tips may reduce a person’s risk of exposure:
- Wear personal protective equipment (facemasks or respirators, eye protection, and gloves) when engaging in higher risk activities
- Only move leaf litter when it is dry
- Avoid moving or digging soil on windy days
- Cover soil and yard materials
- Ensure water has adequate drainage and doesn’t pool near work areas
- Install walkways over wet areas to prevent walking through and disturbing muddy soil
Health officials from PHDM and Michigan Department of Health and Human Services along with Billerud Paper Mill occupational health staff are working together to investigate this cluster of illness. Because the blastomyces fungus is common in the environment in the UP, identifying a specific source or exposure can be difficult. Health officials are making every effort to identify any exposures common among the ill individuals. Information and guidance have also been distributed to local medical providers to assist in the recognition and appropriate diagnosis of blastomycosis.
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