An investigation took place in March for a potentially severe fungal infection that is suspected to be in relation to Escanaba Billerud Paper Mill in Michigan. At least one person has died and almost a hundred more have been sickened. It began when 15 employees had strange diseases that weren’t pneumonia–it was actually a fungal infection called blastomycosis. 

Nineteen more cases were confirmed recently, and 74 others are likely to have the same result. Twelve people reportedly have been hospitalized since.

Billerud Paper Mill is a paper and packaging company from Sweden, which partly explains why there was a fungal outbreak there. According to the Centers for Disease Control and Prevention (CDC), “Blastomycosis is caused by a fungus that primarily lives in moist soil and decomposing organic matter, such as wood, and it spreads through the inhalation of spores.”

This infection can spread to the lungs and other organs, and it is particularly dangerous to those with compromised immune systems. Symptoms include fevers and coughs, but they can worsen depending on the person. More specifically, infected individuals can experience chest pains, muscle aches, and fatigue.

According to Dr. Teresa O’Meara, an assistant professor of microbiology and immunology at the University of Michigan, “These are fungi that live in the environment as a mold and they make spores. What happens is that when people inhale too many of those spores, they can sort of set up and evade some of these innate immune responses and cause pneumonia and spread throughout the body.”

The company has revealed that “Identifying the source of the fungal outbreak can be difficult because the blastomyces fungus is endemic to our area and there has never been an industrial outbreak of this nature documented anywhere in the U.S. from which we can learn.”

Brian Peterson is the mill’s vice president of operations and communicated with the local, state, and federal agencies that held the investigation. Peterson commented, “Although the source of the infection has not been established, we continue to take this matter very seriously and are following recommendations from health and government officials and implementing numerous, proactive steps to protect the health and safety of our employees, contractors and visitors.”

Even though they don’t know where the fungal outbreak came from, the mill recommends employees to wear N95 masks as they hire an industrial hygienist and conduct deep cleanings. 

This type of fungal outbreak is extremely rare, and according to the CDC, there were a total of 240 cases of blastomycosis nationwide in 2019. There are only an average of 26 cases per year in Michigan.

Although the fungal infection can be fatal, there are ways to treat it. Affected individuals can be prescribed an antifungal medication. For example, itraconazole stops the growth of blastomycosis. However, severe infections might call for amphotericin B. It has lots of side effects, which is why it’s only reserved for critical cases.

The good news is that blastomycosis rarely causes death. Hopefully, the Billerud paper mill can recover soon.