Outbreak of Rare Fungal Disease Sickens Nearly 100 Workers at Michigan Paper Mill

An outbreak of blastomycosis, a rare fungal disease caused by the Blastomyces fungus, has sickened nearly 100 workers at a paper mill in Escanaba, Michigan. According to the U.S. Centers for Disease Control and Prevention, people contract blastomycosis after breathing in microscopic fungal spores from the air, often after participating in activities that disturb the soil. After entering the lungs, the spores can be altered by the body's warmth and moisture, converting them into yeast. These yeast cells can either remain in the lungs or spread to other areas of the body, such as the skin, bones, joints, organs, brain, and spinal cord, through the bloodstream.[0]

The Blastomyces fungus is found in moist soil and decomposing matter such as wood and leaves. The region is primarily situated in states bordering the Ohio and Mississippi River valleys, as well as the Great Lakes.[1] Blastomycosis infection is a recognized risk in Michigan's Upper Peninsula. According to a representative from Public Health Delta & Menominee Counties, there has been no record of an industrial outbreak of this magnitude in the United States.[2]

As per the PHDM, the Upper Peninsula (UP) of Michigan is identified as a high-risk region for contracting blastomycosis. It can be challenging to identify the origin since the blastomyces fungus is native to the region, and there is no record of any industrial outbreak of this kind occurring in the United States.[3]

Billerud, the company that owns the mill, said that on March 3, the company learned of a number of atypical pneumonia infections among some of its employees at the Escanaba Mill via the local Public Health Delta & Menominee Counties (PHDM) organization. The company has temporarily idled the mill for up to three weeks for additional proper cleaning based on recommendations from NIOSH and other organizations.[4]

Fever, cough, chest pain, fatigue, muscle aches, and joint pain are all indicative of blastomycosis.[2] The spread of the infection can affect the lungs and other organs. Severe symptoms may be experienced by individuals with compromised immune systems.[5] According to the CDC, individuals may inhale tiny fungal spores, and although the majority will not become ill, a few may experience symptoms such as a fever or cough within three weeks to three months.[6] Occasionally, the infection has the potential to extend beyond the lungs and affect areas such as the skin, bones, brain, and spinal cord.

The issue at the Escanaba Mill in Michigan involves blastomycosis, an infection caused by the Blastomyces fungus which is endemic in Southern, Southeastern, and Midwestern states of the USA and Canada. Michigan's Upper Peninsula is a known risk area for blastomycosis infection. Identifying the source can be difficult because the Blastomyces fungus is endemic to the area and there has never been an industrial outbreak of this nature documented anywhere in the U.S.[7]

An outbreak of blastomycosis has impacted approximately 100 paper mill workers in Michigan's Upper Peninsula, according to public health officials. Person-to-person transmission of the disease is not possible.[8] Only one or two cases of blastomycosis are reported per 100,000 population annually in states that monitor the disease. The CDC discovered that only 1,216 deaths related to blastomycosis were reported in the U.S. between 1990 and 2010, indicating a low occurrence of fatalities from the disease.

According to the company, it received notification of the infections from the Escanaba health department on March 3.[9] The occurrence took place subsequent to a hospital in the vicinity observing multiple instances of “atypical pneumonia infections” among employees of the milling industry. According to a release from the local health department, Public Health Delta and Menominee Counties, some 19 cases of blastomycosis have been confirmed in Billerud employees through biopsies and/or laboratory cultures, with another 74 workers testing as probable cases — having symptoms of blastomycosis with a positive antigen or antibody test from urine or saliva.[10]

A fungal infection called blastomycosis is associated with the growth of fungi in damp soil and rotting organic material, including wood and leaves. If disrupted, it has the potential to become airborne and transmit an infection to an individual through fungal spores.[11] As per the CDC, Blastomyces thrives in damp soil and decomposing foliage and timber. The fungus primarily is found in the Midwest, south-central, and southeast United States, especially in areas surrounding the Ohio and Mississippi River valleys, the Great Lakes, and the Saint Lawrence River.

The Blastomyces fungus is found in the midwestern, south-central, and southeastern U.S., predominantly in the Ohio and Mississippi River valleys, the Saint Lawrence River, and the Great Lakes, per the CDC. Inhaling spores can lead to illness in individuals. Person-to-person transmission of the disease is not possible.[8] The fungal infection present in soil and decaying wood is responsible for causing Blastomycosis, a disease.

0. “Fungal infection outbreak affects 90+ workers at Escanaba paper mill” Detroit Free Press, 8 Apr. 2023, https://www.freep.com/story/news/local/michigan/2023/04/08/fungal-infection-blastomycosis-escanaba-michigan-paper-mill/70092945007/

1. “Fungal Outbreak At Paper Mill Infects Nearly 100 Workers” The Woody Show, 11 Apr. 2023, https://www.thewoodyshow.com/content/2023-04-11-fungal-outbreak-at-paper-mill-infects-nearly-100-workers/

2. “Escanaba paper mill to shut down for 3 weeks over fungal outbreak” WOODTV.com, 14 Apr. 2023, https://www.woodtv.com/news/michigan/escanaba-paper-mill-to-shut-down-for-3-weeks-over-fungal-outbreak

3. “Billerud temporarily idles Escanaba mill in light of continuing blastomycosis investigation” WLUC, 13 Apr. 2023, https://www.uppermichiganssource.com/2023/04/13/billerud-temporarily-idles-escanaba-mill-light-blastomycosis-investigation/

4. “At least 1 dead, 96 sickened in fungal outbreak that shuttered Michigan paper mill” CBS News, 14 Apr. 2023, https://www.cbsnews.com/news/dozens-sickened-1-dead-fungal-outbreak-michigan-paper-mill

5. “Fungal Outbreak Sickens 100 Workers at Michigan Paper Mill” AboutLawsuits.com, 12 Apr. 2023, https://www.aboutlawsuits.com/michigan-paper-mill-fungal-outbreak/

6. “93 confirmed or probable cases of rare fungal infection linked to Michigan paper mill” WTAE Pittsburgh, 11 Apr. 2023, https://www.wtae.com/article/blastomycosis-michigan-paper-mill/43558219

7. “Fungal outbreak at Michigan paper mill suspected to have infected nearly 100 workers” NBC News, 11 Apr. 2023, https://www.nbcnews.com/news/us-news/fungal-outbreak-michigan-paper-mill-suspected-infected-nearly-100-work-rcna79159

8. “Rare fungal outbreak up to 93 likely cases among paper mill workers in Escanaba” WDIV ClickOnDetroit, 10 Apr. 2023, https://www.clickondetroit.com/news/michigan/2023/04/10/rare-fungal-outbreak-up-to-93-likely-cases-among-paper-mill-workers-in-escanaba/

9. “U.P. paper mill pauses operations after blastomycosis outbreak” Fox11online.com, 13 Apr. 2023, https://fox11online.com/news/health-news/upper-peninsula-michigan-up-paper-mill-pauses-operations-blastomycosis-fungal-infection-outbreak-escanaba-billerud

10. “Michigan blastomycosis outbreak: 90+ mill workers infected with fungus” USA TODAY, 11 Apr. 2023, https://www.usatoday.com/story/news/health/2023/04/11/michigan-blastomycosis-fungus-outbreak-escanba-paper-mill/11639816002

11. “U.P. paper mill closing for up to 3 weeks after fungal infection outbreak” MLive.com, 14 Apr. 2023, https://www.mlive.com/news/2023/04/up-paper-mill-closing-for-up-to-3-weeks-after-fungal-infection-outbreak.html

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