ESCANABA, Mich. (WJMN) – On February 28, 2023, Public Health Delta & Menominee Counties (PHDM) was first notified of several atypical pneumonia infections in individuals employed at the Escanaba Billerud Paper Mill. To date, PHDM says there have been 35 confirmed or probable cases of blastomycosis identified among mill workers and an additional nine cases that are awaiting test results.

PHDM, Billerud and the Michigan Department of Health and Human Services are communicating daily during the ongoing investigation. PHDM has interviewed the individuals identified by healthcare providers as having blastomycosis. These interviews assist in determining the approximate timeframe of when the exposure occurred, where the exposure occurred, and possibly how to prevent further exposures to additional individuals.

Blastomycosis is a disease associated with a fungus that grows in moist soil and decomposing matter, such as wood and leaves. People can get blastomycosis infection by breathing in fungal spores from the air. Blastomycosis does not spread from person to person or between animals and people. People at higher risk of contracting the disease include those who:

· Spend time near moist soil (by lakes and rivers)

· Participate in activities such as forestry work, hunting, and camping in wooded areas

· Are exposed to disturbed soil

“The health and safety of our Escanaba employees has been and continues to be our first priority,” said Brian Peterson, Operations Vice President, Billerud Escanaba Mill. “Though no causal link to our mill has been confirmed, we are taking this matter very seriously and have taken a number of proactive steps.”

Peterson said these steps include:

· Conducting extensive cleaning of common areas and inspecting ventilation systems and filters as well as testing raw materials coming into the mill, based on guidance from the Michigan Occupational Safety and Health Administration (MIOSHA)

· Retention of an industrial hygienist to assist with the investigation

· Providing N95 masks to all employees, along with information on how to properly wear the mask

· Requesting the National Institute for Occupational Safety & Health (NIOSH) to perform a health hazard evaluation focused on studying Escanaba Mill employees’ health and safety as well as the wider community

“We will continue to closely communicate with local union leadership, state and local public health officials and our communities,” he added.

Michael Snyder, Health Officer of PHDM said, ““While the Upper Peninsula (UP) of Michigan is a known risk area for blastomycosis infection, it should be noted that these infections are exceedingly rare. Most people who breathe in blastomycosis will not get sick.”

Those who do get sick can develop symptoms such as cough (sometimes with blood), fever, chest pain, difficulty breathing, night sweats, fatigue, weight loss, muscle aches, and joint pain. Persons experiencing these symptoms should contact their healthcare provider.

While there currently is not a vaccine available to prevent the illness, blastomycosis can be treated with antifungal medications prescribed by a medical provider. Treatment is most effective when started as soon as possible after diagnosis by a healthcare provider.

The following tips may reduce a person’s risk of exposure:

· Wear personal protective equipment (facemasks or respirators, eye protection, and gloves) when engaging in higher risk activities

· Only move leaf litter when it is dry

· Avoid moving or digging soil on windy days

· Cover soil and yard materials

· Ensure water has adequate drainage and doesn’t pool near work areas

· Install walkways over wet areas to prevent walking through and disturbing muddy soil

A specific source of the blastomyces fungus causing this outbreak has not been identified. Because the fungus is common in the environment in the UP, identifying a specific source or exposure can be difficult. Health officials are making every effort to identify any exposures common among the ill individuals.

PHDM and Billerud will continue to provide updates about cases at the Escanaba mill and the community at large. Please contact PHDM with any questions by calling: (906) 786-411