At the end of February 2023, workers at the Escanaba Billerud Paper Mill began feeling ill. Their symptoms were reminiscent of atypical pneumonia; some people struggled to breathe. According to reporting from Click On Detroit, Public Health, Delta and Menominee Counties (PDHM) launched an investigation into the cause of these illnesses. Their investigation found that at least 35 individuals working at Escanaba Billerud Paper Mill have been infected with blastomycosis, a rare fungal illness. At least nine other individuals are waiting for their test results to come back.
Though PDHM has noted that the fungus which causes blastomycosis is present throughout Michigan’s Upper Peninsula, the exact source of this particular outbreak is still unknown. But Escanaba Billerud Paper Mill is taking precautions to reduce further spread. These precautions include providing N95 masks for employees, retaining an industrial hygienist, having NIOSH perform a health hazard evaluation, increasing the testing of raw materials being used at the paper mill, and doing deep cleaning throughout the mill itself.
Blastomycosis: An Overview
Merck Manuals describes blastomycosis as:
a pulmonary disease caused by inhaling spores of the dimorphic fungus Blastomyces dermatitidis. Occasionally, the fungi spread hematogenously, causing extrapulmonary disease.
Blastomyces is found in different areas of the environment, such as decomposing wood or leaves, or moist soil. The Centers for Disease Control and Prevention (CDC) share that blastomyces fungi are found most commonly in South-central, southeastern, and midwestern states. These fungi cannot be spread between people, or between humans and animals.
Blastomycosis occurs when the fungal spores become airborne. Many people who breathe in these spores will not get sick. However, some people do get sick, especially if they have other health issues, are older in age, or are immunocompromised in some way. Symptoms typically appear within 3 weeks to 3 months following infection. These symptoms may, but do not always, include:
- Fever and drenching night sweats
- Unintentional weight loss
- A cough that sometimes produces blood
- Chest pain
- Shortness of breath and/or difficulty breathing
- Muscle and joint pain
- Fatigue
In individuals who are immunocompromised, they may develop more severe symptoms such as bone or skin lesions, pleural effusion, acute respiratory distress syndrome (ARDS), or brain abcesses. Therefore, people experiencing symptoms should speak with their physicians immediately. Treatment includes antifungal medications; it is most effective when started as quickly as possible following infection.
