ESCANABA — Despite the Escanaba paper mill being idled, the number of people who worked at or visited the mill that have been infected with the fungal infection known as blastomycosis continues to climb.

To date, there have been a total of 118 cases of blastomycosis identified. Fourteen out of the 118 total cases have been hospitalized. All 118 of the cases are either employees, contractors or visitors of the Billerud Paper Mill in Escanaba. There has been one previously reported death associated with this outbreak.

Although the number of cases has increased by six over the past week, this does not necessarily indicate people are continuing to be exposed to the blastomyces fungus. The incubation period — the time from exposure to the fungus’ spores to the development of symptoms — ranges from 21 to 90 days, and it is likely the cases all stemmed from exposures prior to the mill’s idling.

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. The disease does not spread from person to person or between animals and people.

Most people who inhale the fungal spores do not get sick. On average over the past five years, only 26 cases have been reported for the entire State of Michigan annually. However, the Upper Peninsula of Michigan is a known risk area for blastomycosis infection.

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. Any persons experiencing these symptoms should contact their healthcare provider and discuss whether testing for blastomycosis is recommended.

Blastomycosis is treatable with antifungal medicines, but it is important to get diagnosed early. Most people with blastomycosis will need treatment with prescription antifungal medication. Depending on the severity of the infection and the person’s immune status, the course of treatment can range from six months to one year.

PHDM is continuing to work with Billerud Paper, the Michigan Department of Health and Human Services, the National Institute for Occupational Safety and Health (NIOSHA), and the Centers for Disease Control and Prevention (CDC) to investigate the outbreak.

In addition to the PHDM website, phdm.org, two additional websites have been launched to assist those who may be affected by the outbreak. NIOSH has established a site at www.cdc.gov/niosh/newsroom/alerts/blastomycosishhe.html and Billerud has established a site at escanabamillinfo.com