The Michigan paper mill at the center of what could be one of the largest fungal outbreaks in US history is shutting down for three weeks.
The Billerud paper mill in Escanaba in the state’s Upper Peninsula is at the center of an outbreak of blastomycosis. Officials have confirmed infections in 19 people and they are thought to be behind 74 other diseases. “About a dozen” were hospitalized.
The Swedish company that runs the plant said the closure was a “precautionary measure”. Workers at the plant have told DailyMail.com infections continued while the plant remained open.
The company will use the closure to thoroughly clean high-traffic areas of the plant and its ventilation system and replace filters. It will also test raw materials arriving at the facility to identify the source of the outbreak.
Blastomycosis was first diagnosed at the plant in late February, but it has taken Billerud more than a month to order the closure – initially urging employees to wear face masks to avoid infection.
Pictured above is the Billerud Paper Mill in Escanaba, Upper Peninsula, Michigan, where the eruption was identified
Experts said the outbreak, which involved nearly 100 people, was extraordinary for its size. Outbreaks usually count fewer than 10 cases, they added
The above shows the cumulative number of cases of blastomycosis recorded at the outbreak by date. All patients are believed to work at the Billerud plant, which employs 900 people
Christoph Michalski, Billerud CEO and President, said: “As a precautionary measure, we will temporarily shut down the Escanaba mill for up to three weeks to allow for additional proper cleaning based on recommendations from [health authorities].
“This requires larger parts of the mill to be left vacant while this work is carried out.”
He added: “Although the source of the infection has not been established and we have not received any information from the mill [investigators]… that visiting or working at the mill is unsafe, we take this matter very seriously.’
The company said it was first made aware of the blastomycosis outbreak in early March, when workers first tested positive for the fungus.
Christoph Michalski, the CEO of Billerud, which operates the plant, said it was a “precautionary measure”.
The number of cases has grown to 21 confirmed cases and 76 probable cases since April 7, according to the local health department.
All cases are believed to be among workers at the mill. If the majority of likely cases test positive, it will be the largest outbreak of blastomycosis to date.
The current largest — an outbreak in Wisconsin in 2010 — involved 55 cases, including 30 hospitalizations and two deaths. A source has never been identified.
Gerald Kell, chairman of the United Steelworkers union, which represents workers at the plant, said at least a dozen people have been hospitalized.
Some had to be hospitalized for weeks. There have been no reports of deaths related to the Michigan plant.
Jamie Dier, the union’s vice-president, told DailyMail.com that those who had become seriously ill were “unable to breathe” and were “coughing up blood or phlegm”.
“Your lungs are filling up with nodules [of the fungus]’ he said, ‘there are like fungal masses on their lungs that prevent them from breathing’.
Mr Dier said he was battling a six-week infection with the fungus that left him short of breath and fungal nodules in his lungs, but he has since recovered.
Health officials warn that blastomycosis cases are increasing in the US. In Minnesota, also in the Midwest, data shows infections with the fungus are on the rise
Blastomycosis (stock image of the fungus Blastomyces) can cause symptoms that look like a cold in its early stages, but the fungus can then spread to other areas of the body and cause a more serious illness
Plant managers have been working with health services, including the Centers for Disease Control and Prevention (CDC) and the local Department of Health, to get a handle on the outbreak.
While the mill is shut down, the company plans to thoroughly clean the ventilation system and replace the filters.
They will also clean high-traffic areas of the mill that many workers pass by and test raw materials arriving at the site for the fungus.
Anyone visiting the mill is also asked to wear an N95 face mask to reduce the risk of infection.
A source of the outbreak has not been identified, although the fungus likely entered the facility on rotten or damp wood.
The paper produced by the factory is used in magazines and to make brochures, workers say.
Blastomyces is a mold that lurks in moist soil and foliage in the eastern half of the United States.
People can breathe in its spores, which can infect the lungs and cause a “cold-like” illness with symptoms including a cough, fever, and chest pain.
In severe cases, the fungus spreads from the lungs to other organs, including muscles, bones, and the brain.
The disease has a mortality rate of about one in 100 patients, according to the Centers for Disease Control and Prevention (CDC).
Medications are available to treat the condition, including antifungals — like itraconazole — which work by destroying the wall of fungal cells, causing cell leakage and eventual death.
However, those taking these drugs may need to use them for up to a year to clear the infection.
The infection also doesn’t spread from person to person, public health officials say.
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