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18 Infected in Lincoln County; State Helps Investigate Rare Fungal Outbreak

Posted on: Wednesday, 15 March 2006, 15:00 CST

By KAWANZA NEWSON

At least 18 cases of a rare but potentially fatal fungal infection in Lincoln County 12 of them in the past month have prompted county and state health officials to conduct an environmental investigation in hopes of uncovering the source of the illness.

The infection, known as blastomycosis, killed 16-year-old Merrill High School student Tristan Muenchow on Feb. 14. She is the first person to die in Wisconsin from the infection this year, state health officials confirmed Tuesday. There were seven such deaths in 2005.

Lincoln County typically sees 8 to 10 cases each year, said Shelley Hersil, county health officer.

Though county health officials aren't sure why cases of blastomycosis spiked in the county, they say that the infection is not contagious and that people shouldn't stop going outdoors.

"We're just telling people in the county that if they experience symptoms to please go see their doctor to be evaluated, because it's not easily detected," Hersil said.

Common symptoms of blastomycosis are pneumonia and a skin rash that starts reddish and may become crusted or ulcerated. Early symptoms can include fever, cough, weakness, weight loss and chest aching.

Hersil said the cases in Lincoln County began Jan. 19 and involve adolescents to seniors. The infection has about a 45-day incubation period before symptoms appear, she said.

Blastomycosis develops when spores of the fungus Blastomyces dermatitidis are inhaled into the lungs. The fungus is believed to live in acidic soil with high organic content, abundant moisture and possibly enrichment by animal droppings. The spores become airborne when the soil in which the fungus is growing is disturbed.

According to the Centers for Disease Control and Prevention, only about 50% of people who inhale the spores become symptomatic.

"This is very common in dogs because they're running around with their noses in the ground, but very rare in humans," said John Archer, an epidemiologist with the Wisconsin Division of Public Health.

However, people with weakened immune systems are at higher risk of becoming ill, he said.

Tristan Muenchow was hospitalized with a severe case of pneumonia on Feb. 13, according to her grandmother Diana Huston.

Tristan became ill about a week after her father, Steven Muenchow, was hospitalized with blastomycosis on Feb. 4, Huston said. Tristan was diagnosed with pneumonia, treated with antibiotics and allowed to go home.

On Feb. 13, Tristan's condition had dramatically worsened. She was flown to St. Joseph's Hospital in Marshfield, where she suffered two heart attacks and was pronounced dead early the next morning, Huston said.

She was buried with a cell phone to keep in contact with those who loved her, a Special Olympics gold medal for the snowshoeing events she loved and a 2007 letter jacket.

Statewide, an average of 99 cases of blastomycosis were reported each year between 2000 and 2004. According to the state Division of Public Health, Lincoln County had 45 over those five years, more than any other county, followed by 40 cases reported in Milwaukee County.

The Milwaukee County cases involve exposure to the fungus elsewhere, including northern Wisconsin, said Paul Biedrzycki, Milwaukee's manager of disease control and prevention.

Copyright 2006, Journal Sentinel Inc. All rights reserved. (Note: This notice does not apply to those news items already copyrighted and received through wire services or other media.)

Source: Milwaukee Journal Sentinel

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