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Northland tops state for Blastomycosis
Grand Rapids, Minnesota - Herald-Review
By Charles Ramsay Mesabi
Read online: http://www.grandrapidsmn.com/special_sections/article_5a1f9c92-c8e3-11e0-b43f-001cc4c002e0.html

Blastomycosis may not be on many people's lists of diseases to watch out for in the Northland, but it might help residents and visitors alike to be aware of some of its signs, and dangers.

St. Louis County had a significant toll of human cases among counties in the state over an eleven-year period, 94 out of a total of 349, said Joni Scheftel, a Minnesota Department of Health public health veterinarian.

"It's our number one county for numbers of cases," she said.

Itasca County is No. 2.

The state measures cases by two different methods: Residence and exposure.

"Where they live and where they are exposed are two different things," Scheftel said. "We interview everyone who is a Minnesota resident."

Typically there are about 35 human cases a year, and around 65 canine cases, she explained. Blastomycosis cannot be transmitted between the two, but cases do bear similar symptoms, mainly fungus from turned-over soil.

There is a long incubation period for the disease, 40 to 90 days or more. Anyone exposed is asked about where probable exposure occurred, where they had been or what kind of exposure there was, in the 90-day period prior to onset.

There is a band of counties across the Northland that report cases, she said.

In the 1999-2009 period, by exposure, St. Louis County had the highest number of cases, 81, with Itasca County the next highest, with 23 cases. In that time, cases by residence reported were: St. Louis County, 94; Hennepin County, 30; Itasca County, 27; Ramsey County, 22.

Visitors to the Northland may be exposed while in the area, then go back home where incubation develops. A doctor may not recognize the disease, and a diagnosis may be delayed.

"It's when people vacation in St. Louis County and come back to the Twin Cities," where such cases can develop, Scheftel explained.

Humidity, climate, weather, nearness to waterways and types of soil can determine where cases of blastomycosis can originate. Moist soil, rich with decomposing organic matter such as leaves, sandy soil, and rich soil near waterways can all contribute.

"No one really knows why you do get this from the soil," she said.

There can be more cases if local conditions are wet early in the year, and then it becomes dry and windy later, when spores are more likely to be blown.

Moving soil by excavation, or by disturbances such as four-wheeler trail riding, may be factors. Longevity can play a role, with 45 years the median age.

"It tends to be a disease of middle-aged men," Scheftel said, with ages of victims ranging from 4 to 93 years and who are 70 percent male.

Most cases can range from mild to moderate, with maybe a cough, a fever, draining and skin lesions present. But fungal pneumonia can develop, and for a minority of cases "when it's severe, it's a bad disease," she added.

If a person has a cough, with fever, that is not responding to antibiotics and doesn't go away in a week, they should consult a medical professional, she said.

Guy Peterson of the St. Louis County Department of Public Health and Human Services said that "there's really no prevention" for blastomycosis, but cases are rare. Doctors and veterinarians are required to report cases, however.

An outbreak of the disease occurred in Mountain Iron in 1999, with a number of cases. There was some development going on, and "there was higher than normal rain," he said.