A deadly fungus that kills up to one in five people it infects may be more common than previously thought, a study suggests.
People catch the fungus behind blastomycosis by inhaling spores released by disturbed rotten wood or leaf litter, which can then take root in the lungs and spread to the skin, brain and spinal cord, causing fatal pneumonia and inflammation.
Officials have previously suggested the disease is not common, and the infection is only being tracked in five states – mainly in the Midwest.
But researchers at the Centers for Disease Control and Prevention (CDC) are now suggesting the opposite, after finding that the fungus is more common in Vermont than in four of the five states where it is being tracked.
The map above shows states where cases of blastomycosis are confirmed (red), recently confirmed (orange), or suspected (blue)
A study of tens of thousands of health insurance claims found that the disease had 1.8 cases per 100,000 people in Vermont between 2011 and 2018.
But in 2019 and 2020 this rose to three cases per 100,000.
By comparison, in four of the monitoring states – Arkansas, Louisiana, Michigan and Minnesota – the rate did not rise above one per 100,000 during the same period.
It was only higher in Wisconsin, where the average was around three per 100,000.
The researchers wrote in the paper: ‘Our findings are consistent with a growing body of evidence suggesting that the burden of endemic blastomycosis is greater than commonly appreciated.
‘These results challenge routine assumptions about the epidemiology and ecology of this disease and reflect the need for future research.’
They added: ‘Physicians should consider blastomycosis in patients with compatible signs and symptoms.’
Blastomycosis is a disease caused by the fungus Blastomyces, which can lurk around waterways and in moist soil and leaf litter.
Patients infected with the fungus may experience a mild to moderate infection that causes coughing, fever and chills.
Sonya Cruz, 31, and mother of one, from Wisconsin, pictured with her husband John Cruz on their wedding day in 2019. She died last year of blastomycosis
Blastomycosis (stock image of fungus Blastomyces) can cause symptoms similar to a cold in the early stages, but the fungus can then spread to other parts of the body, causing a more serious illness
But in severe cases, they can develop within days to weeks into pneumonia, lesions on the skin – which appear as bumps, blisters or sores – and neurological problems – warning signs of encephalitis, or swelling of the brain.
This happens because the fungus can spread throughout the body through the bloodstream or lymphatic system and cause damage in other areas.
Infections are diagnosed through a blood or urine test and can be treated through the administration of antifungal medications such as itraconazole, which has the brand name Sporanox.
In addition to the five states reporting the disease, cases have also previously been confirmed from Illinois, Missouri and Mississippi.
But all of these states are located around the Mississippi River basin, making the detection of the fungus in Vermont an outlier.
Last year, more than a hundred people were sickened by the mold at a paper mill in Michigan – the largest outbreak in US history. Thirteen people were hospitalized and one person died.
A mother of one in Wisconsin also died from the yeast infection after doctors initially missed the infection and sent her home with antibiotics.
Sonya Cruz, 31, developed breathing problems shortly before her death and had to be put on a ventilator and sedated.
Her husband John said at the time: ‘They have taken away my right. I’m not saying the hospital or whatever. Whatever this is, I brought my wife.”
Vermont claims data showed that 116 people had been diagnosed with the infection between 2011 and 2020.
Of the patients, 34 were hospitalized and four also reportedly died from the disease.
In Vermont, three of the north-central counties — Lamoille, Orleans and Washington — reported the most cases.
Researchers used the Vermont Health Care Uniform Reporting and Evaluation System, which covers about 75 percent of the state’s residents, to collect the data.
Insurance claims were checked for diagnosis codes 116.0 or B40.X, indicating plastomycosis infection.
Most patients were men – about 60 percent – and had an average age of about 55 years.