A rare fungus that has killed eight and infected almost 200 people and hundreds more animals in British Columbia appears to have migrated to Washington.
Through environmental sampling, scientists have found cryptococcus gattii in Whatcom County and fear it may continue moving south, said Rebecca Baer, an epidemiologist who tracks the fungus for the Washington State Department of Health.
Two of the four Whatcom County residents who tested positive for cryptococcus gattii have died from the disease, according to Joni Hensley, communicable disease supervisor for Whatcom County. Altogether, seven Washingtonians have become ill from the fungus in the past two years.
“It seems to have spread south,” said Dr. Eleni Galanis, a physician epidemiologist for the British Columbia Centre for Disease Control. “At this point it’s hard to say whether it will go farther.”
Cryptococcus gattii emerged in the central part of the eastern Vancouver Island coast in 1999. Invisible to human eyes, the microscopic fungus grows on trees, floats in the air and can even live in water. People and animals can become infected by breathing in the spores. However, not everyone who is exposed to the fungus becomes ill. The disease is not contagious, and scientists don’t believe it can be passed between animals and humans.
Since its arrival in British Columbia, cryptococcus gattii has spread throughout the coast of Vancouver Island. In late 2004, the fungus was detected on the mainland. At least six people have become infected in the Vancouver and the Fraser Valley regions who had not traveled to Vancouver Island prior to falling sick, researchers found.
The disease first appeared on Washington land in 2005, when three Whatcom County cats died from the fungus, Baer said.
Since then, four Whatcom County residents from the Canadian border to Bellingham and three people living in other Washington counties have become ill with cryptococcus gattii. In order to protect their identities, the Washington Department of Health isn’t saying where the other three people with cryptococcus gattii live.
However, Baer said the Department of Health doesn’t know of any cases in Snohomish County.
While Baer said she’d like doctors to report cases of cryptococcus gattii to the state, they’re not required to. So there may be more cases out there.
At the Snohomish Health District, officials are waiting from guidance from the state before they begin tracking the disease, spokeswoman Suzanne Pate said.
“It’s smart to think regionally about any kind of disease,” she said. “I can’t say I’m any more worried about this than I would be about chlamydia or sexually transmitted diseases, which are very high statistically up and down the interstate corridor.”
In Whatcom County, public health officials sent information to every doctor in the county on cryptococcus gattii in early spring, asking them to look out for the illness and report any cases.
“It’s very interesting because it’s obviously an emerging disease,” Baer said. “We weren’t seeing it before and we are now. However, I don’t think the average person needs to be concerned. They should be aware there is this emerging disease … but not change their behaviors based on it.”
At first researchers weren’t sure whether people in Washington were exposed to the fungus here or during travels, but some of the more recent cases involve people who have not traveled outside the state to areas with a known cryptococcus gattii presence. The fungus can live in people for two to 12 months before they become ill.
Symptoms include cough, chest pain, headaches, shortness of breath, fever, night sweats and weight loss. The fungus can cause pneumonia and form nodules inside the lungs. It can also spread through the bloodstream to the brain, sometimes causing meningitis.
Courtney Blomeen, 16, of Blaine, first thought she had a severely strained shoulder muscle last month when her father took her to the doctor. She also suffered from what she thought was an unrelated chest cold. It turns out Courtney had cryptococcus gattii.
When her father, Greg Blomeen, looked at the CAT scan of his daughter’s chest, he was so scared, he said, he couldn’t breathe.
“Her left lung had completely blocked off,” Blomeen told The Bellingham Herald. “There were marble-sized nodules that were showing bright white. It was so bad that the one lung was at collapse.”
The fungus usually lives in tropical and subtropical places like Australia and Brazil. Scientists aren’t sure how it arrived in British Columbia. The two prevailing theories are that it was either accidentally carried here from its native environment, or that it lived undetected in British Columbia for centuries, but didn’t cause problems until recent climate changes triggered a response.
The disease has killed close to 30 harbor porpoises in the Pacific Northwest since 1999, as well as llamas, ferrets and dogs in British Columbia.
“I don’t think we’ve seen the end of this,” Galanis said. “I think it’s a very interesting time. As this disease continues to change, especially its range, we have to keep a close eye on it, but I don’t think it’s going to spread indeterminately.”
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