Blastomycosis fungus typically found along great inland waterways
by Guy Page
A new study by the CDC and the VT Dept. of Health has found evidence of a sometimes fatal fungal lung disease afflicting Vermonters, most often in the north-central part of the state.
The disease is called blastomycosis. More often than not it requires hospitalization and has a death rate of 4-22%. Between 2011-2020 it affected about two patients for every 100,000 Vermonters – about 12 people per year.
The study, “Using Insurance Claims Data to Estimate Blastomycosis Incidence, Vermont, USA, 2011–2020,” was published online in a February, 2024 CDC publication and authored by researchers affiliated with the U.S. Centers for Disease Control and the Vermont Department of Health.
“The epidemiology of blastomycosis in Vermont, USA, is poorly understood. Using insurance claims data, we estimated the mean annual blastomycosis incidence was 1.8 patients/100,000 persons during 2011–2020. Incidence and disease severity were highest in north-central counties,” the study reported.
The landlocked location is puzzling because blastomycosis is typically found along the nation’s great inland waterways: Ohio and Mississippi Rivers, Great Lakes, and the St. Lawrence Seaway. Only five states – none in the northeast – monitor for blastomycosis.
“Blastomycosis is a rare but potentially fatal fungal disease caused by Blastomyces spp., a group of thermally dimorphic environmental mycoses found in moist soil and decaying organic matter. Human illness most often results in pulmonary conditions but can involve any organ system,” the study reports.
Clinical manifestations range from subclinical infection to life-threatening disease. Associated illness and death rates are high; among symptomatic persons, hospitalization rates are 57%–69% and death rates 4%–22%. It is treated with antifungal medications such as itraconazole.
The study data was retrieved from the Vermont Health Care Uniform Reporting and Evaluation System (VHCURES), an all-payer health insurance claims database managed by the Green Mountain Care Board. VHCURES includes insurance claims data from medical, dental, and pharmacy encounters for all Medicare and Medicaid recipients and about 75% of Vermont residents with commercial insurance.