Last summer, four Laborers and one carpenter developed serious illness while renovating a bridge in Watseka, Illinois. One of the Laborers was hospitalized for six days. The symptoms included high fever, chills, cold sweats, achy bones and joints, fatigue, a non-productive cough and pain and heaviness in the chest.

Responding to the Illinois Histoplasmosis Outbreak

When his members became ill, Laborers’ Local #751 Business Manager Mike Smith called the Midwest Region Laborers Health and Safety Fund (MRLHSF). Literature regarding Histoplasmosis was immediately sent to the local and the contractor.

Smith also involved the local and state health departments which, in turn, contacted the Centers for Disease Control. The federal Occupational Safety and Health Administration (OSHA) got involved and made work practice recommendations to the jobsite supervisors.

John Condis, Safety Officer for the MRLHSF, visited the jobsite and discussed safety and health concerns with the company and the resident engineer from Illinois Department of Transportation (IDOT). The incident was discussed at the quarterly IDOT work zone safety committee meeting, and MRLHSF provided appropriate IDOT officials with the Histoplasmosis booklet and the LHSFNA bird droppings health alert.

What was it? A potent flu bug? No, it was a potentially serious infectious disease called Histoplasmosis.

Histoplasmosis is an infection caused by inhaling a fungus, Histoplasma capsulatum. The fungus is common in soil, especially in soil contaminated by pigeon or bat droppings. In the United States, the fungus is found most often along the Mississippi and Ohio River valleys but also is present in other central, southeastern and mid-Atlantic states. The disease is transmitted to humans by airborne fungus spores rising from the soil. Although primarily associated with soil, the fungus has been found in droppings (particularly from bats) alone.

According to the National Center for Infectious Disease (NCID), how ill a person becomes after an exposure varies greatly and most likely depends on the number of spores inhaled, a person’s age and individual’s susceptibility to the disease. Often the disease is asymptomatic, yet it can develop into chronic disease, especially in immune compromised individuals. A person can learn from a Histoplasmosis skin test whether he or she has been previously infected by the fungus.

Mild cases of Histoplasmosis are usually resolved without treatment. For severe cases, special antifungal medications are needed to arrest the disease. One of the Illinois Laborers was treated with Sporanox, an anti-fungal drug, which costs $1,023.00 per month. His doctors expected him to take the medication for several months.

To prevent similar illness elsewhere, Laborers must develop an awareness of the risk factors and prevention measures associated with exposure to bird and bat droppings. These are summarized in the LHNSFNA health alert, “Bird and Bat Droppings,” available in English and Spanish (developed originally by the New England Laborers Training Academy). A NIOSH publication, Histoplasmosis: Protecting Workers at Risk, is available at 1-800-35-NIOSH. This comprehensive, 26-page booklet includes information regarding causes, diagnosis, risk communication, personal protective equipment and waste disposal as related to Histoplasmosis. A summary sheet for workers in both English and Spanish is included in the document.

[Angie King is the Director of the Midwest Laborers’ Health and Safety Fund.]