The following article originally appeared in the Kenora Miner
& News. It is reproduced here with the permission of
the Kenora Miner & News.
Kenora Miner & News
Shauna DeGagne
Oct. 2001
Blastomycosis can be beaten
By Elsie Neufeld
By Shauna DeGagné
Miner and News Staff
Four years ago, local resident Nicole
Theriault was sick.
She knew something was seriously wrong
with her, but doctors couldn't figure it out.
Large cysts were appearing under her
skin, making daily living very uncomfortable.
"It felt like someone was squeezing
everything inside of me," said Theriault, a mother of a
young daughter. "It felt like arthritis."
After two years, Theriault found a cyst
in her breast while doing a self-examination. Thinking it was
breast cancer, she had surgery to get it removed. It turned
out to be non-cancerous. She also had a cyst the size of a
softball removed from her elbow.
Because Theriault didn't have a family
doctor, it was hard to keep track of what was going on but
finally, after a trip to the emergency room because her elbow
wasn't healing properly, the mystery was solved.
Theriault had blastomycosis.
All it took was a swab test of her elbow.
She said the results were ready the next day.
Doctors prescribed ketoconazole and
although the medication helped get rid of the cysts, Theriault
said she had really bad migraine headaches because of it.
She stopped taking the pills after six
months, but the blasto returned.
She is currently taking a low dose to
control the infection.
Theriault thinks she probably inhaled the
blasto fungus in the house she was living in at the time, as
it had a soil basement.
In total, Theriault had eight surgeries
to remove cysts from various areas on her body, including her
chest and shoulders.
"They were multiplying pretty
fast," she said.
Sounds pretty scary.
But Theriault's case is rare, said Lyle
Wiebe, environmental/occupational health and safety
professional for the Northwestern Health Unit.
Theriault said she thinks she was only
the fifth person in Kenora to be diagnosed with blasto.
"(Most people who get blasto) inhale
the fungus spores and yeast grows in their lungs," Wiebe
said.
He said blasto can also cause 'ulcerated
lesions,' usually to people who have gotten blasto because an
open scrape or cut was exposed to the fungus.
Sixty-three cases of blasto among humans
were investigated by the health unit in 1999-2000. Numbers for
this year aren't available yet, but the health unit continues
to work with Manitoba Health to track incident numbers through
studies and questionnaires.
Blasto can hit animals
Dr. Celia Christensen of the Kenora
Veterinary Clinic said 46 cases of dogs with blasto were
reported in 2000. In 1999, 90 cases were reported.
This year, the clinic is seeing more
cases than last year.
"If it's a dry season, we won't see
as much," she said.
She, like many other people in Kenora,
said our area seems to see a lot more cases than other areas.
"We're definitely the blasto capital
of Canada," she said.
Dr. Christensen said to avoid blasto, you
should assume it is everywhere and take precautions. She said
that whenever possible, you should stop your pet from digging
in soil.
Gail and Bernard Benoit of Keewatin never
thought their 16-month-old golden retriever, Bessy, could get
blasto. After all, their last dog lived for 17 years and never
encountered the disease.
But a couple of weeks ago, the Benoits
started noticing changes in their dog's behaviour.
"She wasn't her old self, wasn't as
energetic," Gail said. "Then came the cough."
The Benoits wasted no time getting Bessy
to the veterinarian.
At the vet, Bessy had her temperature
taken and she did have a fever, a common sign of blasto. The
vet took an X-ray and found the dog had a spot on the far back
corner of her lungs. This could have been one of two things:
cancer or blasto.
The tests came back and unfortunately,
Bessy had blasto. She was given an 80 per cent survival rate
because of her age and good health.
"My first thought was 'where did she
get it?'" said Gail.
The only place Bessy plays is in her own
yard and in the ball park/playground down the hill from the
Benoits' home.
Bessy was prescribed a heavy dosage of
sporanox, the drug commonly given to pets with blasto.
Twenty one pills meant $103 (plus tax)
out of the Benoits' pocket.
Bessy had to take one and a half pills
twice a day. This proved to be a hard task.
Gail said she tried getting her dog to
take her medicine any way she could. She wrapped the capsules
in cheese, which worked for a little while, then tried hiding
the pills in a spoonful of cheese spread.
"The double dose really ruined her
appetite," Gail said. "It was totally nil."
After one week, Bessy headed back to the
vet.
This time around, her lungs sounded
clearer.
Her medication was cut down to one and a
half pills, just once a day.
Gail said Bessy has started to get her
energy back and is eating a bit more.
"She is getting more perky and her
nose is cold and wet. Her cough isn't that often now,"
she said. "She's doing OK, so far."
The Benoits say early blasto detection is
the key.
"The earlier you catch it, the
better off you are," Gail said.
Still, Gail said she has a lot of
unanswered questions. Like why do some dogs get it and others
don't? And why don't we have a lab where our soils could be
tested?
Bessy isn't the only dog in her
neighbourhood with blasto. The Benoits report that a handful
of dogs in their area have the disease, and wonder how many
more dogs have it without anyone knowing.
"People should be aware of
this," Gail said.
"Your dog is a part of your
family."
Blasto
symptoms
Does your dog have blastomycosis?
If your dog has these symptoms, bring her
to the veterinarian as soon as possible.
-chronic, persistent cough
-trouble breathing
-doesn't want to exercise
-losing weight
-fever
-poor appetite or no appetite
-depression
(taken from the Kenora Veterinary
Clinic's info. sheet)
Common
questions
What is blastomycosis?
Blasto is an infection of humans, dogs,
cats and other animals caused by the fungus blastomyces
dermatitidis found in soil. The infection affects the lungs
and skin, sometimes resulting in pneumonia or crusted,
ulcerated pimples.
How can you get blastomycosis?
You can get blasto by breathing in the
fungus or getting it on a scrape or cut. Since this fungus is
in the soil, construction, digging or gardening may cause the
fungal spores to be carried into the air and inhaled. You
cannot get blasto from another person or animal.
Where is it found?
The fungus is found in acidic, moist soil
in parts of Northern Ontario, Manitoba, Saskatchewan, Quebec
and in other areas around the Great Lakes and Mississippi
rivers. There is no lab available to test soils for the
organism because handling of infected soils can cause human
infections.
Who is at risk?
Anyone can get blasto, but the risk is
very low. Most healthy people are resistant to it. The body's
natural defences fight the fungus and prevent illness. The
risk is higher for anyone who is often exposed to moist soil
that contains a lot of rotting leaves and wood. This condition
can be more severe in people who have a weakened immune
system.
What are the symptoms?
Blasto may seem like the flu, with a
persistent cough, muscle aches, joint pain, tiredness, chills
and fever. These symptoms may develop suddenly, days to weeks
after exposure to the fungus. Some may develop a persistent
cough with yellow or green spit. This may be the first sign of
pneumonia. A blasto infection usually starts in the lungs but
can cause a skin infection.
What should you do if you think you may
have blasto?
Tell your doctor. The doctor will want to
know if you have been in a high-risk area and in contact with
soil or dust. Without treatment, blasto can become a serious
illness.
Avoiding blasto
There is no vaccine for blastomycosis,
but you can take precautionary measures to prevent it. Wear
work gloves, proper footwear, long pants, a long-sleeved shirt
and a disposable filter dust mask when working in moist soil
areas where the fungus may grow. These areas include under
your house, cottage, porch or shed. Wearing these items does
not guarantee you won't get blasto, but remember that the risk
of getting it is very low.
-taken from fact
sheets from the Northwestern Health Unit and the Kenora
Veterinary Clinic
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