ESCANABA — More than 100 people who have visited or worked at the Escanaba paper mill and been infected blastomycosis, a fungal respiratory infection, according to Public Health Delta & Menominee Counties.

To date, there have been a total of 104 cases (confirmed and probable) of blastomycosis identified. A confirmed case is a person with symptoms of blastomycosis and where the fungus has either been grown (culture) or seen by microscope in a test specimen. A probable case is a person with symptoms of blastomycosis and who has a positive antigen or antibody test. PHDM will no longer be reporting the number of confirmed and probable cases separately, as all reported cases have a blastomycosis diagnosis.

Thirteen out of the 104 total cases have been hospitalized. All 104 of the cases are either employees, contractors or visitors of the Billerud Paper Mill in Escanaba.

There has been one previously reported death associated with this outbreak. That individual was a contractor who was working at the mill.

PHDM is continuing to work with Billerud Paper Mill, Michigan Department of Health and Human Services, National Institute for Occupational Safety and Health (NIOSH), and Centers for Disease Control and Prevention to investigate the outbreak of blastomycosis.

Blastomycosis is a rare 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.

Most people who inhale the fungal spores do not get sick. 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.

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. Any persons experiencing these symptoms should contact their healthcare provider and discuss whether testing for blastomycosis is recommended.

Blastomycosis is treatable with antifungal medicines, but it is important to get diagnosed early. Most people with blastomycosis will need treatment with prescription antifungal medication. Depending on the severity of the infection and the person’s immune status, the course of treatment can range from six months to one year.

In addition to the PHDM website, https://phdm.org, two additional websites have been launched to assist those who may be affected by the outbreak. NIOSH has established a site at https://www.cdc.gov/niosh/newsroom/alerts/blastomycosishhe.html and Billerud has established a site at https://escanabamillinfo.com.