A recent outbreak of blastomycosis at a paper mill in Michigan has caused the death of at least one worker, and sickened 96 others. The Escanaba Billerud Paper Mill has been shut down to tackle the unprecedented outbreak, with federal investigators looking into the potential causes of the typically rare and lethal fungal infection. Of the 96 patients with symptoms, 21 cases have been confirmed through laboratory testing, while the remainder are considered probable having tested positive in an antibody or antigen test.
Blastomycosis is caused by inhalation of spores created by the fungus Blastomyces. Moist soil, decaying wood, and leaves are prime breeding grounds for the fungus, and half of those exposed to spores will develop symptoms similar to those experienced with common respiratory illnesses such as fever, fatigue, and coughing.
The location of this outbreak is unusual, with only 26 cases being reported across the entire of Michigan in any given year. The Michigan outbreak is presumed to have come from the paper mill, but the CDC have warned of a similar outbreak in several Wisconsin neighbourhoods caused by construction work.
The CDC’s NIOSH has urged Billerud’s management to take additional precautions to combat future cases of blastomycosis. Measures recommended by the CDC include inspecting the plant’s ventilation systems, halting excavations, which can stir up soil, and providing N95 respirators to employees. Federal investigators plan to offer urine tests to employees, collect samples throughout the campus, and administer questionnaires to workers that could help track the original source of the fungus.
Blastomycosis, when left undiagnosed, can be fatal, particularly in those with weakened immune systems. Severe cases can cause the fungus to spread into other areas of the body, requiring surgery. Billerud has announced it will temporarily idle the plant for up to three weeks to allow for additional cleaning of the site based on NIOSH’s recommendations.
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