The Fungus Among Us: Blasto Isolated in the Home Environment

During 2010 a large outbreak of Blastomycosis, a potentially life-threatening fungal infection caused by Blastomyces dermatitidis, occurred in Marathon County, Wisconsin. A disease investigation was conducted by the local health department in conjunction with the Center for Disease Control and Prevention (CDC), the State of WI Dept of Health and Marshfield Clinic.  The investigation included environmental sampling within recognized cluster areas of soil, air and rodents.  Blastomyces has only been successfully identified in the environment twice in relation to human illness.  Sampling in this outbreak led to the discovery of a Blastomycosis isolate from the basement of a home where unrelated tenants who lived in the home in succession were diagnosed with Blastomycosis.  Recommendations were developed to reasonably remediate the basement in response to the positive air sample result. The presence of the CDC heightened the concerns of the community.  Policies were challenged by both the media and the community creating a controversy over the disclosure of locations and the confidentiality of diagnosed individuals. This presentation will discuss the benefits and disadvantages of environmental sampling for Blastomyces.  In addition, the importance of public communication through the press and how it can impact various aspects of a community will be examined.