Blastomycosis – Part five of a health series

Health administrator doesn’t count pennies

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—Following questions from the public surrounding the test for blastomycosis (the fungal disease contracted from decomposed vegetable matter in soil and found on Manitoulin Island), The Expositor spoke with Manitoulin Health Centre (MHC) CEO Derek Graham, who has a background in laboratory testing from his time as a lab technician turned manager.

He explained that fungal cultures are not performed in the MHC lab, but at Public Health Ontario labs (in the North there is one in Sudbury and another in Sault Ste. Marie).

If a physician orders a culture of sputum (phlegm) or blood, and fungal elements are picked up by the technician, a sample is then forwarded on to Public Health Ontario, even when a culture for fungus was not ordered, he explained.

“But it’s got to be in the sample, and it’s not always there,” he added.

In the case of blastomycosis, a sputum sample is best received by a more invasive measure, such as a chest scope, rather than “horking” up phlegm for a culture, Mr. Graham explained. For blood tests, there is a 70 to 90 percent chance of finding blasto in a sample, he added.

He added that physicians’ decisions about ordering tests for their patients are not based on a “money saving venture but about appropriateness of care.”

“There is no one standing there with a calculator,” he added. “All of this has to be put into context,” Mr. Graham added, saying he realized that blastomycosis is top-of-mind with many Islanders as of late with the death of Sheguiandah’s Gwen Young. “We see viral respiratory issues 100 times more than fungal.”

The Expositor left messages with Public Health Ontario to enquire as to the cost of testing for blastomycosis, but these calls were unanswered as of press time Monday.