Blastomycosis: Island within blasto’s ‘hot spot’

EDITOR’S NOTE: While blastomycosis is not a new health hazard on Manitoulin Island, it is rare enough here that its symptoms are not easily recognized by the general population. This health feature series, prompted by a recent tragic fatality linked to the condition, will examine aspects of the disease, how best to avoid contracting blastomycosis and some of the possible symptoms people can exhibit. It will talk to the medical and scientific community, survivors of the disease and the family of the individual fatally infected with blastomycosis.

MANITOULIN—A recent death in the community of Sheguiandah from the rare fungal infection blastomycosis, one some citizens are calling avoidable, has raised considerable concern among residents about the sometimes deadly spore lurking in Island and area soil and the way it is contracted.

On January 3, Gwen Young of Sheguiandah passed away at Health Sciences North in Sudbury. Just before her death, test results revealed that Ms. Young had been suffering from the effects of blastomycosis, a fungus she would have come into contact with on her Island home and which ultimately caused her death.

According to the website of the Sudbury and District Health Unit (SDHU), “blastomycosis (blasto) is a rare fungal infection caused by breathing in a fungus (blastomyces dermatitidis), which is found in wood and damp soil. Exposure may also occur by getting the fungus on a skin scrape or cut.”

In a telephone interview with Burgess Hawkins, manager, environmental health, with the SDHU, The Expositor learned that the blasto hot zones for Ontario include the Great Lakes (and Manitoulin) with Kenora as the main hot spot for Ontario. Cases have also been reported as far north as Chapleau.

As the disease is not communicable (able to be spread from one person to another) blasto is no longer reportable, Mr. Hawkins explained, noting that the SDHU does not have numbers on cases but had heard about the death of Ms. Young “through the grapevine.”

Blasto, he continued, is a fungus or mould that grows best in soil with high organic content (rotten wood or vegetation) and low pH levels.

“It’s extremely hard to find,” Mr. Hawkins said. “When we test, we rarely find it,” he added, noting that it is extremely hard to culture the spores in a lab as the requirements for it to live are very specific. “Island soil is slightly acidic, there are lots of trees and vegetation so it could grow without a problem.”

After numerous cases of blasto in Chapleau in recent years, the medical officer of health for the area tried to conduct a study with soil samples taken from each of the suspected contract areas, but did not succeed once.

Once a person comes into contact with blasto, the incubation period is large, Mr. Hawkins explained, from three weeks to three-and-a-half months, before an infected person begins to exhibit symptoms.

While you can contract blasto from open sores or cuts, it is rare; it is most often contracted by breathing in the fungal spores. It cannot be contracted through the water table, the SDHU assures, and this is something Northeast Town CAO Dave Williamson wants Northeast Town residents, including those in Sheguiandah, to know as well.

“There is no possibility that blastomycosis could be found in treated water,” he emphatically told The Expositor. “The treatment and process is designed to meet provincial standards. Blastomycosis is a fungal spore found in soil. There is no risk of blasto from drinking water from a treated system.” A rumour in the Northeast Town following Ms. Young’s unfortunate death was suggesting blasto could be contracted through drinking water.

Mr. Williamson said his office has fielded several calls from anxious residents and events coordinator Heidi Ferguson has already been in contact with the SDHU to hold a public information session on blastomycosis in the spring “to mitigate these concerns.”

Mr. Hawkins said blasto is “extremely difficult” to diagnose as the symptoms are varied and wide and include a persistent cough, muscle aches, joint pain, tiredness, chills, low-grade fever, skin sores or unexplained weight loss. The diagnosis can be made from a sample of saliva, pus from skin lesions or urine, depending on the symptoms. The risk of getting blasto is low, but those with weakened immune systems should be aware, the SDHU urges.

“These symptoms are really generic and blasto is reasonably rare,” Mr. Hawkins added. “It’s not one (disease) you think of right off the top. But there is a test for it, and there is treatment for it.”

“If you have these pneumonia-like symptoms, mention that you live in an area with blasto,” he added. “An Island doctor would likely be more aware of it.”

He noted that the SDHU has released information sheets to Manitoulin doctors twice over the last two years.

“Farmers, forestry workers, hunters and cottagers may be exposed at wooded sites after disturbance of contaminated soil,” the SDHU website states. “About half of people exposed to (blasto) will develop mild to severe illness.”

Mr. Hawkins suggests using caution when working in confined areas with rotted wood and keeping track of time and dates. Wearing an N100 mask, gloves and a long-sleeved shirt is also suggested.