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Health, Science, Environment

Rare fungal infection suspected among more Joplin residents

This article first appeared in the St. Louis Beacon, June 14, 2011 - State health officials say they have received reports of 10 suspected cases of a potentially fatal deep skin fungal infection among some of those injured during last month's tornado in Joplin. The report seems to be the first state comment about how many suspected cases have come to its attention.

Officials didn't say whether there might be other suspected cases, but the announcement shows that the situation is fluid. Just yesterday, officials at the Department of Health and Senior Services had mentioned nine reported cases.  They updated that number to 10 today.

Spokesperson Jacqueline Lapine said the agency "is not confirming any deaths related to the reported fungal infections." She said samples taken from the suspected cases are being subjected to further testing at the Centers for Disease Control and Prevention in Atlanta.

The infection is known as zygomycosis. Lapine says the fungi that cause the infection are commonly found in soil and decaying wood.

"The disease occurs more often in individuals with uncontrolled diabetes and immune disorders, but may occur in healthy individuals after trauma. In patients with traumatic injury, the fungi may cause wound infection in the injured area.

"Infected wounds usually do not heal and are painful. Patients might experience fever. Severe illnesses develop in some patients. Cases of deep skin fungal infection have been previously reported after natural disasters."

She said the infections cannot spread from human to human. All of the cases, she said, related to individuals who "sustained trauma from the tornado with secondary wound infections."

Dr. Benjamin Park, an epidemiologist at the CDC, said the infection can be severe and aggressive.

"Unfortunately, we don't keep track of this infection," he told the Beacon. "There aren't really good estimates of how prevalent it is, but what we can say is that we do know that this infection is quite rare. A large hospital might only see a handful of these infections in an entire year."

Having a "cluster of suspected zygomycosis infections after a natural disaster is quite unusual. It's not something that we usually see."

He stressed that all the samples from Joplin remain "suspected cases at this point, but if they are confirmed, it is a high number."

He said the state was taking the lead in the investigation, and that the CDC was playing a supportive role, such as analyzing samples sent to it.

He said one lesson to be learned from the disaster is to keep tracking suspected cases. People who might have wounds that aren't healing should seek medical attention.

Symptoms requiring immediate medical attention, Lapine said, included "swelling, redness or inflammation, tenderness or pain, heat in the area of the wound, and fever."

Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.

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