ESCANABA, Mich. (Michigan News Source) – The cases of confirmed and probable cases of blastomycosis tied to the Billerud Mill in Escanaba has climbed to 104, Public Health Delta and Menominee Counties (PHDM) reports.

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PHDM said one person has died from the outbreak, and 13 of the 104 total cases have been hospitalized. The cases involve employees, contractors, and visitors of the paper mill.

PHDM said it will no longer be reporting the number of confirmed and probable cases separately, as all reported cases have a blastomycosis diagnosis. In addition, PHDM will continue to work with the National Institute for Occupational Safety and Health (NIOSH), and Centers for Disease Control and Prevention to investigate the outbreak.

The paper mill has been idled for several weeks so crews can clean the facility. Billerud officials said the company will continue to pay its employees during that time.

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Blastomycosis is a disease associated with a fungus that grows in moist soil and decomposing matter like wood and leaves. It is not spread person-to-person; rather, people get blastomycosis by breathing in fungal spores from the air.

Those who do get sick can develop symptoms including coughing up blood, fever, chest pain, difficulty breathing, night sweats, fatigue, weight loss, muscle aches, and joint pain. Most people with blastomycosis are treated with prescription antifungal medication.