‘Oddball’ disease lurks in Kenora area

Hey there, time traveller!
This article was published 07/08/2003 (8337 days ago), so information in it may no longer be current.

IN early March, Bill went to a Winnipeg walk-in clinic about a pimple on his face that just wouldn’t go away.

A little over a week later, he couldn’t see and the “pimple” had grown as wide as a loonie and stood out from his face like a second nose.

After surgery to remove the growth — and a chunk of his face — it just kept growing.

Half an hour before he was due to be wheeled in for a second surgery, the biopsy results came back.

“Bill,” who does not want his real name used, had been attacked by a fungus that grows in the soil of northwestern Ontario. Health officials suspect he picked it up last fall when he helped his father clear trees at a lake near Kenora.

Inside Bill’s lungs, doctors found two pear-sized growths. At Christmas, he had felt a bit weak, but the active 43-year-old figured he was just getting older and slower.

The blastomycosis hasn’t entirely cleared up yet and Bill expects to be on heavy-duty anti-fungal medication for months.

His friends were unnerved that an outdoorsy, fit guy like Bill would be vulnerable to a serious disease most people have never heard of.

“If I can get it, anybody can get it,” he said.

Blastomycosis can kill, especially if patients are misdiagnosed.

The “oddball” disease that causes everything from boils to pneumonia is easy to mistake for other problems, especially because it’s so rare that most doctors have never seen it.

The Kenora area is the world hot spot for a disease also found along the Mississippi and Ohio river valleys and in the U.S. Great Lake states.

Dean Hunter picked up the disease when his rock band, Damn Straight, played at Sioux Narrows on Lake of the Woods on Canada Day, 2002.

He spent “a lot of nights in pain” before doctors figured out what was causing the five centimetre growth on the back of his scalp. “It was like a horn almost.”

The Kenora region had an average of 29 cases per year from 2000 to 2002. Manitoba has about 10 to 15 cases a year, but many are among people who have spent time at cottages in the Lake of the Woods area, said Dr. John Embil, a blastomycosis expert who is director of infection control for the Winnipeg Regional Health Authority.

The incidence in the Kenora region is far higher than recorded anywhere else, but health officials say that could be because doctors in the area are looking for it.

There are no reliable statistics before 2000, when the disease became officially reportable by doctors to public health officials. A widow whose husband died after being misdiagnosed lobbied for the change.

Dogs are also susceptible to blastomycosis because they root around in the dirt.

Hunter said he would have been “a goner” if Embil had not diagnosed him. “It was eating away at the skull — any longer and it would have got to my brain.”

The band’s guitarist also got blastomycosis, but it hit his lungs.

Bill wonders why he got sick when his Dad was not infected.

No one knows

That’s one of the mysteries of blastomycosis. No one knows whether some people are genetically predisposed to pick up the fungus or what activities are most risky. It’s also unclear whether certain spots have a higher concentration of spores that people breath into their lungs, but there’s speculation that Kenora’s moist, acidic soil might foster growth of the fungus.

Because the disease can incubate for months before people get symptoms, it’s hard to trace back to the original source. People cannot pass the disease to other people.

Embil is recruiting people who have had blastomycosis and their family members to try to answer some of those questions. Kenora officials are eager to get the answers to quell fears of the unknown that could potentially affect tourism in the region.

Lyle Wiebe, an inspector with the Northwestern Health Unit in Kenora, said people should probably wear masks if working with dirt in a confined space, like under a cabin.

Another Winnipeg man believes he picked up the fungus while digging in the mud under his cottage in December after the plumbing leaked. The man said he was taking cortisone for neck problems, so his immune system was suppressed at the time.

Bill said he will keep spending time in the bush. “I’m not going to change my life.”

Embil is looking for people willing to fill out a questionnaire and give a blood sample or skin scraping for genetic analysis.

By comparing people who got the disease to family and neighbours, who did not, he hopes to sort out who is most susceptible.

He is collaborating with the Northwestern Health Unit, the University of Alabama and the U.S. National Institutes of Health, but has been unable to get grant funding.

Volunteers can contact the Health Sciences Centre at 787-2967 or the Northwestern Health Unit at 807-468-3147, extension 264.

helen.fallding@freepress.mb.ca