PORT TOWNSEND — A man living off Discovery Road in Port Townsend is recovering from Cryptococcus gattii in the first confirmed case of human infection by the potentially deadly fungus on the North Olympic Peninisula.
Where Rudolfo Von Lelyveld, 60, contracted the fungus is unclear, but Dr. Tom Locke, public health officer for Clallam and Jefferson counties, said he has seen no indication of a source on the Peninsula.
Von Lelyveld has been taking anti-fungal medication since his condition was diagnosed in April, and is feeling better than he has since December, when he first came down with what he thought was the flu.
“I’m feeling much better,” he said Wednesday.
“I’m eating better. I don’t have the fatigue or the night sweats or the headaches.”
Be aware, get treated
His recovery is due to getting the correct diagnosis before the infection progressed, said his wife, Deborah Von Lelyveld.
“People need to be aware of this disease,” Deborah Von Lelyveld said.
“If they have a cold that won’t go away they need to ask their doctor to pay attention to this possibility.”
Treatment involves six to eight weeks of intravenous antifungal medications followed by months of pills.
The airborne fungus, which is native to tropical regions, appeared on Vancouver Island in the late 1990s.
It moved into the U.S. in 2004, and last month, experts said that the strain had appeared in Oregon — and had mutated to become more lethal than the British Columbia strain.
But infection is rare in Washington state. Until Von Lelyveld’s case, it had been seen only in Whatcom, King and San Juan counties, with only eight or nine cases total, Locke has said.
Locke said there are many unknowns about the fungus, such as where it can be found, how it spreads and how it came to the region.
But the one certainty, according to Locke, is that it is not contagious.
C. gattii is not transmitted from person to person or carried by insects or animals. Rather, the fungus forms spores that are blown in the wind or moved by soil disturbances of the soil.
It also isn’t life threatening, keeping in mind that any infection can take a turn for the worse and cause unforeseen complications.
“This is a very rare condition,” Locke said. “And it’s treatable as long as it’s diagnosed correctly.”
In Von Lelyveld’s case the diagnosis took a while.
He began experiencing respiratory distress in December. He thought he had the flu. But it didn’t go away.
After a series of tests, he received a call in early April that told of several “shadows” on his lungs.
Fears of cancer
While stopping short of an absolute diagnosis, the word “cancer” was tossed about several times, he said.
Under this cloud, he received three scans in the following two weeks which turned out to be inconclusive.
During this time, his large family rallied around him.
His three children and other relatives provided support, and people gravitated to his home with the purpose of saying goodbye.
The potential diagnosis of lung cancer reminded Von Lelyveld that he had smoked in his youth.
He stopped when a girl that he liked said she wouldn’t see him unless he quit.
That girl is now his wife, and the couple recently celebrated their 35th anniversary.
On April 21, a lung biopsy at Olympic Medical Center in Port Angeles showed that he did not have cancer, but instead the rare fungus.
More energetic
Now, Von Lelyveld, who has lost weight, feels more energetic.
And family members, who arrived ostensibly to ease him out of life have remained in town to share the reprieve.
“When we heard that it was not cancer we were elated,” his wife said.
“But then we discovered we were dealing with a completely different situation.”
After the diagnosis, family members wore face masks while in his presence. They were doing so during an April 26 patient visit to the University of Washington Medical Center in Seattle.
“We all had on these masks and could barely breathe,” Deborah Von Lelyveld said.
“A team of doctors came in without masks and started talking to us, so we asked them why they didn’t have their masks on.
“It was then that they told us that it wasn’t contagious.”
Locke said he became aware of the case shortly after the diagnosis but held off on any public announcement until tests were conducted. Locke did not identify the patient. Von Lelyveld went public with his condition himself.
Origin unknown
Testing continues at the Centers for Disease Control in Atlanta, which has been unable to determine the origin of the fungus that infected Von Lelyveld.
The most likely candidates are Oregon or British Columbia. He has traveled to both locations recently.
Another possibility is Hawaii, where Von Lelyveld visits regularly as part of his home-based retail business.
People who stir up the soil — landscapers, loggers, outdoor recreationalists — are the most likely to encounter the fungus.
“Even then, the risk of human exposure is fairly low,” Locke has said.
People who want to take preventive steps should wear face masks if their job requires them to stir up excess vegetable matter.
And if they are suffering from flu-like symptoms that do not subside after a reasonable time they should seek medical attention.
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Jefferson County reporter Charlie Bermant can be reached at 360-385-2335 or at charlie.bermant@peninsuladailynews.com.
