By The Daily News

ESCANABA — The number of people infected with blastomycosis who worked at or visited the Billerud paper mill in Escanaba continues to climb, but health officials say it is likely all were initially exposed to the fungus before the mill idled two weeks ago.

A total of 109 cases of blastomycosis had been identified as of Friday, will all either being employees or contractors with Billerud or having visited the mill. Thirteen of the 109 cases required hospitalization and one person died due to the outbreak.

Although the number of cases has increased by five 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 before the mill was shut down for deep cleaning.

“While we continue to see new cases testing positive for blastomycosis and being reported to Public Health Delta and Menominee Counties, we continue to see fewer new cases being reported each week and many of these cases have been showing signs and symptoms since March,” PHDM Health Officer Michael Snyder said.

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 in 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 health care provider and discuss whether testing for blastomycosis is recommended.