Fungal infection at Michigan paper mill kills 1, sickens nearly 100

Local and federal investigators investigate source of rare blastomycosis outbreak at paper mill in Escanaba, Michigan

At least one person has died and nearly 100 people have fallen ill in a rare fungal outbreak at a Michigan paper mill, health officials said, prompting the plant to temporarily close as investigators locals and federals are trying to identify the source.

The blastomycosis outbreak at the Billerud Paper Mill in Escanaba, Michigan has escalated since February.< /p>

Local health officials initially identified about 15 probable cases. By mid-April, that number had risen to 21 confirmed cases and 76 probable cases. Twelve people were hospitalized and one person died.

All reported cases involved workers, contractors or plant visitors.

Billerud, a Swedish paper and packaging company, said on Thursday it planned to close the plant for three weeks starting next week to carry out deep cleaning , inspect ventilation systems, replace filters and test various raw materials entering the plant, which employs around 830 people. The additional cleanup requires large parts of the plant to be empty, he said.

"Identifying the source can be difficult as the Blastomyces fungus is endemic to the region," he said. the company said in a statement. "There has never been an industrial outbreak of this nature documented in the United States."

Blastomycosis is an infection associated with the fungus Blastomyces, which grows in damp soil and decaying matter, such as wood and leaves, and can spread through the air if disturbed.

Blastomycosis infections are rare. In 2019, the United States Centers for Disease Control and Prevention reported 240 total cases of blastomycosis.

On average over the past five years, only 26 cases have been reported in all of Michigan, according to the local health agency. However, the agency noted that Michigan's Upper Peninsula is a known risk area for blastomycosis infection.

According to the C.D.C., "blastomycosis remains misunderstood". The fungus lives primarily in the Midwest, South-Central, and Southeast states, particularly in areas around the Ohio and Mississippi Valleys, Great Lakes, and St. Lawrence River.

Most people who breathe in Blastomyces spores will not get sick. Symptoms include cough (sometimes with blood), fever, chest pain, difficulty breathing, night sweats, fatigue, weight loss, muscle pain and joint pain.

< p class="css-at9mc1 evys1bk0">Symptoms appear three weeks to three months after exposure. Blastomycosis can be treated with antifungal drugs.

The first patients' symptoms began in January and February, authorities said.

A team led by the National Institute for Occupational Safety and Health visited the plant on March 27 and 28 after a request from Billerud, according to an April 7 letter from Marcia Stanton, a agency's health scientist, which was published by CBS.

The agency advised the company to make N95 masks available to reduce the potential exposure and to inspect the ventilation system and ductwork for "evidence of water incursion and microbial growth" while investigations continued.

Saturday, the C.D.C. said in a statement that it plans to return to the plant in late April to offer testing for Blastomyces urine antigen in the event of a potential exposure. Participation would be voluntary.