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http://www.wausaudailyherald.com/article/20100401/WDH0101/4010409/Blasto-cases-jump-in-county

Blasto cases jump in county
19 have been diagnosed with fungal infection so far this year

By Jake Miller • For the Wausau Daily Herald • April 1, 2010

The number of reported cases of a rare fungal infection have spiked in Marathon County, already nearly matching totals for all of 2009, a health department official said.

Nineteen people throughout the county have been diagnosed since Jan. 1 with blastomycosis, a fungal spore that can grow in the lungs of humans and animals, said Ruth Marx, a Marathon County Health Department epidemiologist.

"It's more than we would expect to see, so we do consider it a spike," Marx said.

The county recorded 24 cases in 2009 and 26 in 2008, Marx said.

Patients recently found to have blastomycosis most likely were infected in late fall. Symptoms typically take one to three months to appear, Marx said.

Spring and fall are the most likely times for blastomycosis exposure to occur because growth relies upon strict environmental factors. The fungus typically is found in sandy soils or decaying wood and vegetation, which has been exposed in recent weeks as snow has melted. Bodies of water where water levels fluctuate also are common growing grounds, Marx said.

With warmer weather in the forecast -- temperatures in Wausau jumped into the 70s on Wednesday for the first time this year -- the department is alerting residents that blastomycosis could be active, Marx said.

Anyone spending time outdoors, particularly in wooded areas, should be aware of the symptoms, which often are similar to pneumonia and include fever, a dry cough and chest pain.

"There is some rough correlation with outdoor activities," said Dr. Thomas Sell, an infectious disease physician at Marshfield Clinic, "but it's such a rare illness that it doesn't make sense for people to avoid the outdoors."

Most of the cases reported this year occurred east of Wausau, though long gestation periods make it difficult to pinpoint where people were infected, Marx said.

Humans are infected when they inhale blastomycosis spores, which become airborne when soil is disturbed, often during gardening or landscaping, she said.

Bob Schumacher, owner of Schumacher's Family Tree Nursery in Marathon, said his closest encounter with blastomycosis was about 10 years ago, when a customer reported it near his home.

He said he's not concerned with the reported spike.

"We're just taking it day by day," he said. "We're not panicked or worried about it. If something turns up, it turns up."

Treatment can take up to six months, Sell said, for mild cases, and involves taking a pill daily. More severe cases can lead to hospitalization. Sell said there are two or three patients now at Saint Joseph's being treated for blastomycosis.