3 dead after suspected blastomycosis outbreak in Constance Lake First Nation

Three people have died following a suspected outbreak of blastomycosis, a fungal lung infection, in the Constance Lake First Nation, northwest of Timmins, Ont.

Luke Moore, 43, died on Nov. 19. His family said he was treated in the northeastern Ontario town of Hearst for pneumonia symptoms, before the community suspected blastomycosis.

His father, Arthur Moore, said his son's body is now in Toronto, where they are awaiting results on the cause of his death. While the family says that death and two others in the community have been linked to blastomycosis, the chief has said that hasn't been confirmed.

Luke Moore's mother, Elizabeth Moore, said her son was healthy and strong. She added he was well-liked in the community.

"And he has some beautiful grandchildren here in this home," she said." After asking about grandpa, we are telling them that grandpa's in heaven."

Patient transfers, ICU cases

In a news release, the Notre-Dame Hospital in Hearst said it has transferred 10 adults and six children with symptoms to other hospitals across Ontario.

As a precautionary measure, the hospital has cancelled all surgeries this week so that the surgical department can focus on patients with blastomycosis symptoms. 

Greater Sudbury's Health Sciences North Hospital confirmed it had two patients from Constance Lake First Nation in its intensive care unit Monday afternoon, and two more patients were to arrive later in the day.

In a Facebook video published on Monday, Constance Lake First Nation Chief Ramona Sutherland said four cases of the infection have been confirmed so far, through laboratory tests. She also confirmed a dog died, possibly from the infection.

Sutherland said the band council declared a state of emergency Monday afternoon. The declaration opens the community to more provincial and federal support.

 Algoma-Manitoulin-Kapuskasing MP Carol Hughes said she has been in contact with the community, along with federal and provincial colleagues to assist and determine the source of the outbreak.

"I want to send a message of condolences and healing thoughts to the community of Constance Lake First Nation who are struggling with multiple confirmed and suspected cases of blastomycosis which has led to a growing number of hospitalizations, the loss of community members, and a search for answers about the source of exposure," she said.

A fungal infection

Blastomycosis is an infection caused by a fungus called blastomyces. Symptoms include a fever, cough, night sweats, chest pain, fatigue and muscle aches.

Severe cases can spread from the lungs to other parts of the body, such as the skin, bones and joints, and the central nervous system.

The fungus is generally found in the soil in certain wooded areas in North America, said Dr. Anna Banerji, an infectious disease specialist with the University of Toronto's Dalla Lana School of Public Health.

"What happens is that people, you know, maybe they're walking through the woods or they're moving piles of wood or decay or leaves and they inhale it," Banerji said. "So it's spread through inhalation."

She said the infection cannot be spread between people. It can be fatal if someone has a weakened immune system, but is also treatable with a common antifungal.

"It's not something that's widespread to all of Ontario," Banerji said, about the fungus that causes the infection.

Searching for source of spores 

The source of the outbreak has not been pinpointed yet, according to a public health physician with Indigenous Services Canada.

Dr. JoAnn Majerovich says the investigation began last Friday after the first suspected case.

"We believe we may be looking for a single exposure," she said during a Facebook live on Monday.

"What I mean by that is it may be, the single event may be a picnic around a lake where there happened to be blastomycosis spores. I'm saying that as an example right now. We don't know what the exposure is at this point."

She said because the disease takes weeks to months to develop, it's believed people were exposed to the spores some time ago, possibly as far back as the spring.

Majerovich says weather is on their side and is likely protecting community members from ongoing exposure.

"Blastomyces doesn't like the winter, the cold or the snow and it doesn't thrive or do well in the frozen soil."

Sutherland urged anyone in the community with symptoms to go to the hospital as soon as possible.

"Do not think you can tough this out, just go to a hospital," she said.

She said the community was working closely with Health Canada, and in contact with hospitals in larger urban centres in northeastern Ontario, in case anyone needed to be airlifted for treatment.

Provincial response 

"The situation on the Constance Lake First Nation is truly saddening and our deepest condolences go out to the families who have lost loved ones as a result of the current emergency in the community," Ontario's Ministry of Health said in an email statement.

The ministry said its Emergency Operations Centre was working closely with local provincial and federal partners to respond to the situation.

Notre-Dame Hospital in Hearst is co-ordinating with hospitals in North Bay, Timmins, Greater Sudbury and Ottawa to support patients from the community, the statement said. 

"Indigenous Services Canada is also looking at providing additional nursing supports to the community nursing station (in Hearst)," the email said.

The ministry added Public Health Ontario has started an environmental health investigation in the community. The Ornge air ambulance service is transporting lab samples to a Public Health Ontario lab in Toronto.