Author Topic: Blastomycosis in Will County 12/11/2014 Plea for action  (Read 3796 times)

Offline tomanyaussies

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Blastomycosis in Will County 12/11/2014 Plea for action
« on: January 07, 2015, 09:49:40 AM »

The Dogs
A dog died at the age of three at 1215 Spencer Rd., New Lenox, IL, in December, 2013, drowning in his
own blood while suffering from multiple skin sores that oozed pus. He was under diagnosed for having
only a MRSA-resistant bacterial infection and treated with antibiotics to no effect. A second dog has
shown identical symptoms a year later and has been definitively diagnosed with blastomycosis. He is
being treated the same as a person might be, namely, with antibiotics and itraconazole, an antifungal
medication which is effective but expensive.

People
Supporting documentation include reports stating dogs are a sentinel species meaning dog infection is a
warning of the potential for blastomycosis in people (Herrmann, 336; Bradsher, 192, Reiss, 125).
Blastomycosis can be contracted by any creature that breathes and has the correct body temperature.
Infection occurs primarily through inhalation, although certain other forms of entry into the body are
possible, such as through the eyes, this according to the Center for Disease Control. Additional reports
identify blastomycosis as mimicking other common ailments therefore leading to misdiagnosis
(Bradsher, 188; Khuu, 1790; Roy, 661). Furthermore, in a study that addressed the misdiagnosis of
blastomycosis, it was found to be correctly diagnosed in only 5% of the cases (Reiss, 131). Reports
identify the blastomycosis as causing serious respiratory illness, serious pulmonary illnesses,
disseminating into bones, skin, genitourinary structure, and death (Anderson, 386, 390; Chapman,
1803). There is no way to prevent blastomycosis and reports identify some people as having greater
susceptibility, particularly those with diabetes, other immune-deficient conditions, children and the
elderly (Pfister, 64). Medical reports recommend early diagnosis by suspecting the possibility of fungal
infection in every occurrence of common respiratory ailments (Anderson, 390; Khuu, 1790). They
recommend the efficient and timely transfer of information between government and private
organizations concerned with public health (Khuu 1793; Roy, 661; Herrmann, 342; Carlos, 1381;
Dworkin, e111). This is best facilitated by making blastomycosis a reportable disease in endemic areas,
in which Illinois is included, but the reporting thereof is not. Several reports posit that blastomycosis
infections have been increasing in recent years (Khuu, 1790, 1792; Anderson, 387).

Current Government
Blastomycosis was removed as a reportable disease in 2008 by the state of Illinois (Herrmann, 336) at 32
Ill. Reg. 3777, an alteration of administrative code. Illinois has not recorded a clustering of the diagnosis
in humans since. It is recordable in Wisconsin, which had a reported outbreak in September, 2009
through June, 2010 (Roy, 655).

The Will County Land Use Department directed an inquiry regarding the canine death to the county
veterinarian, Dr. Schild, who responded that there were no county ordinances specifically directed at
blastomycosis and it was not reportable to the Illinois Department of Agriculture, therefore no action
was required by his department. Additional questions were raised to him by email regarding rumored
cases around horse barns in Crete and those remain without a response. Land Use also directed this
inquiry to the Director of Environmental Health, Elizabeth Bilotta, who responded by saying that her
department does not have the capability to detect this vector.
Upon being notified the Illinois Environmental Protection Agency has stated that it will return the call at
some undisclosed point in the future.
Blastomycosis Habitat
According to the Center for Disease Control and Prevention, blastomycosis is endemic to the Southeast
and Midwest regions of the country. The disease is most prevalent in areas with large amounts of
decaying, organic material, rotting wood, acidic soil, and areas with heavy moisture or close proximity to
water (Hannah, e151-152; Herrmann, 335; Khuu, 790; WDNR, 1). It has also been linked to yard waste
and animal fecal matter (Hannah, e152; Roy, 655; Pfister, 64).
It is assumed that the fungi are everywhere in the soil, which seems to be analogous to radiation being
everywhere on the planet. There are, however, areas where the concentration becomes considerably
greater than in the majority of the natural world. Those areas become health hazards. The assumption
that the fungi are everywhere leads to an erroneous conclusion that only those susceptible become
victimized. Nothing can be done, it simply happens to them. The reports do not agree with those
assumptions because there are incidents where clusters and outbreaks occur (Roy, 655-656; Carlos,
1377-78). If the assumption holds true that the fungi are everywhere, waiting in the soil, then
circumstance leads to its proliferation and densification wherein the spores form in a number sufficient
to become toxic. This can occur naturally, but more importantly as a result of manmade action. There
are reports of infection occurring around construction sites where it is assumed the simple act of
opening an excavation causes the release of spores (Carlos, 1380; Hannah, e152). Perhaps decaying
woody wastes were unearthed or perhaps deposited as a product of the construction. Sawdust does not
seem to be included in the category of woody waste by the local authorities.
The Illinois EPA commented that the use of sawdust to soak up animal waste is a common practice.
Adjacent to 1215 Spencer Road, this is a practice and sawdust with manure is arbitrarily applied to the
soil without any limitations. That application includes an area that is submerged in water periodically
and overflows 250 feet across residential property into a creek. It is not unusual to find sites where barn
wastes, in a non-composted state, are continuously applied to an area that drains onto residential
properties and into waterways. This application does not take into account the assimilation of this waste
into the soil before application is made again and again. It is simply a way to empty the barns. There
exists code prohibiting this action but the enforcement is lacking.

As a reminder, the medical profession repeatedly states that early diagnosis is the only effective
treatment of blastomycosis, which in most instances is indicated by a symptom associated with other
respiratory ailments. The government failure to enforce their own code, to report an infectious disease,
and to coordinate effective treatment is a health risk at the sites where this practice is habitual, as it is
also to the residents within an effective area. Reports indicate that the spores in an airborne state have
caused infection to a distance of 400 meters (1300 feet) (Pfister, 62).
In Will County, current zoning has allowed the continued existence of small farms that have the right to
contain an unlimited amount of animals. Many of these sites are 2.5 acres, near or adjacent to greater
and greater densities of people. Current zoning allows an unlimited number of animals at 10 acres with
an A-1 zoning. Other zoning has limitations such as one horse per acre. Farms are imagined to be much
larger than this and have a great deal of room to rid themselves of their waste products, but these sites
are attempting to do so within the confines of their property. Unlimited animal density translates to
unlimited manure if in fact no one will enforce those codes. Again, locally, several of these sites are
within range of residential neighborhoods, churches, and schools.
Government action to date has been to review the situation concerning manure and sawdust then file
reports that indicate there are no problems. They are, in essence, giving it their stamp of approval.

Plea for action
So far, sawdust appears to be considered as a product and not a waste. Reports can say woody waste
and one imagines an old branch with bark on it, stuck in the mud. The potential for sawdust to present a
friendly and accommodating surface area for what is a microscopic spore is a significant multiplier over
the presentation that occurs in nature. Sawdust is a waste product of varying composition and should be
handled as such. There are proper ways to dispose of it and to recycle it that need to be enforced.
Blastomycosis as a disease is subtle, possibly fatal, possibly crippling, and expensive to treat.
Blastomycosis is produced most frequently and most intensely in a cocktail of decomposing, organic,
woody, wetland type soil in a low oxygen state. Moist soil inoculated with manure and sawdust is that
on steroids. For the safety of the citizens of Will County we request appropriate action to be taken
concerning this significant health threat.

Signed,
The staff at Browning Engineering, LTD.


Bibliography
Anderson, Evan J., et al., “Blastomycosis in Children: A Study of 14 Cases” in Journal of the Pediatric
Infectious Diseases Society 2013; 2(4):386-390
Bradsher, Robert W. Jr., “The Endemic Mimic: Blastomycosis an Illness Often Misdiagnosed” in
Transactions of the American Clinical and Climatological Association 2014; 125:188-203
Carlos, W. Graham, et al., “Blastomycosis in Indiana: Digging Up More Cases” in CHEST 2010;
138(6):1377-1382
Chapman, Stanley W., et al., “Clinical Practice Guidelines for the Management of Blastomycosis: 2008
Update by the Infectious Diseases Society of America” in Clinical Infectious Diseases 2008;
46:1801-1812
Davis, J.G., and D. Whiting, “Choosing A Soil Amendment” in Colorado State University Extension Fact
Sheet #7.235, accessed 12/08/2014 www.ext.colostate.edu
Dworkin, Mark S., et al., “The Epidemiology of Blastomycosis in Illinois and Factors Associated With
Death” in Clinical Infectious Diseases 2005; 41:e107-111
Hannah, Elizabeth Lyon, et al., “Public Health Response to 2 Clinical Cases of Blastomycosis in Colorado
Residents” in Clinical Infectious Diseases 2001; 32:e151-153
Herrmann, John A., et al., “Temporal and Spatial Distribution of Blastomycosis Cases Among Humans
and Dogs in Illinois (2001-2007)” in J Am Vet Med Assoc 2011; 239(3):335-343
Khuu, Diana, et al., “Blastomycosis Mortality Rates, United States, 1990-2010” in Emerging Infectious
Diseases 2014; 20(11):1789-1794
Pfister, John R., et al., “Non-Rural Point Source Blastomycosis Outbreak Near a Yard Waste Collection
Site” in Clinical Medicine & Research 2011; 9(2):57-65
Reiss, Errol, et al., Fundamental Medical Mycology, Hoboken, NJ: Wiley-Blackwell. 2012.
Roy, Monika, et al., “A Large Community Outbreak of Blastomycosis in Wisconsin with Geographic and
Ethnic Clustering” in Clinical Infectious Diseases 2013; 57(5):655-662
Wisconsin Department of Natural Resources, “Blastomycosis Awareness and Yard Materials
Management”, in WA 1173 Rev 2007:1-3