Sexually Transmitted Ringworm Outbreak Raises Concerns in Minnesota
Minnesota is currently grappling with the most significant outbreak of a sexually transmitted form of ringworm in the United States, with a notable proportion of cases affecting men who have sex with men. Since July of last year, the state has recorded over 30 confirmed or suspected instances of this fungal infection, all concentrated within the Twin Cities metropolitan area, according to the Minnesota Department of Health.
This particular strain of ringworm, identified as trichophyton mentagrophytes genotype VII (TMVII), was initially identified in New York City in June of the previous year. Health authorities in Minnesota have indicated that the Centers for Disease Control and Prevention (CDC) is aware of other isolated cases appearing in major urban centres across the US. Previously, the California Department of Public Health had reported that the first diagnosed individual with TMVII had travelled to California before being identified in New York. While TMVII has been circulating in Europe and among individuals who have travelled to Southeast Asia for sex tourism over several years, it has not yet been deemed widespread throughout the US.
Understanding TMVII: Symptoms and Transmission
TMVII stands out as the sole known sexually transmitted fungal infection, as noted by the Cleveland Clinic. Often mistaken for common skin conditions like eczema or psoriasis, TMVII is transmitted through direct skin-to-skin contact or exposure to fungal spores. The infection can spread through intimate contact, but also to other parts of the body, including the face, buttocks, torso, arms, and legs.
The hallmark symptom of TMVII is a painful and intensely itchy, red, coin-shaped rash. These lesions can sometimes present with small bumps or pimples on their surface. The severity of TMVII infections can vary considerably. In some instances, even with treatment, complications can arise. Patients may develop lesions and open sores, which significantly increase the risk of secondary bacterial infections and can lead to considerable inflammation. Health officials have issued warnings that some individuals may experience persistent and painful rashes that could result in scarring or lead to more severe infections requiring antibiotic treatment.
Diagnosis and Treatment Challenges
Accurately diagnosing a TMVII infection presents a challenge, often requiring specialised laboratory testing. The CDC notes that many laboratories struggle to differentiate TMVII from two closely related fungal infections, T. mentagrophytes and T. interdigitale.
The treatment regimen for TMVII can be lengthy and demanding. Patients may require several weeks, or even months, of oral antifungal medications. It is crucial to avoid the use of steroid creams, as these can exacerbate TMVII infections.
Prevention Strategies
To minimise the risk of exposure and transmission, public health officials recommend several preventative measures:
- Avoid Sexual Contact with Visible Rashes: Individuals should refrain from sexual contact if they or their partner exhibits a new or suspicious rash.
- Do Not Share Personal Items: Avoid sharing personal items such as clothing, towels, bedding, and razors, as these can harbour fungal spores.
- Hygiene and Laundry Practices: All contaminated items should be washed and dried using high heat settings. Fungal spores can be effectively killed using common household disinfectants or strong detergents.
- Cover Infected Areas: If someone suspects they have a rash, it should be covered with bandages or clothing.
- Hand Hygiene: Thoroughly wash hands with soap and water after touching any potentially infected area to prevent spreading the fungus to other parts of the body.
While the overall public health risk associated with TMVII is considered low, state health officials have highlighted that certain groups may be at a higher risk. These include men who have sex with men, individuals who utilise anonymous dating applications, and those with a history of sexually transmitted infections. This information was shared by the University of Minnesota’s Center for Infectious Disease Research and Policy.
