It sounds like a bad B movie, a toxic fungus in the woods of the Pacific Northwest drifting into peoples' lungs, causing illness and death.
But cryptococcus gattii is out there and has affected a handful of Oregonians, most recently a Junction City woman hospitalized for more than four months this fall.
In the Northwest it was first detected on Vancouver island in 1999, where it has sickened about 180 residents and killed eight, said Karen Bartlett, associate professor of environmental health at the University of British Columbia. The disease is still rare.
Previously it was associated with tropical and subtropical climates. Nobody is quite sure how it wound up in Oregon.
Bartlett said it may have arrived on an imported plant or bird. Others say it may have been here for a long time, unnoticed until changes in climate or land-use patterns allowed it to grow in high enough concentrations to become airborne.
Even small changes in climate, such as an increase in temperature of a degree or two, can cause changes to microscopic organisms that are in dynamic balance with each other, she said.
Once the fungus is established in soil or in trees, it can float in the air in dry weather, she said, causing an infection in the lungs, or more seriously, in the central nervous system, causing fungal meningitis.
Symptoms include severe cough and shortness of breath, often accompanied by chills, night sweats and anorexia.
Until 2004, the only human cases in Canada were found among people who lived on or had traveled to Vancouver Island.
In 2004, when the first case was found in someone who had never been to the island, researchers began looking elsewhere and found other cases including two in Oregon.
One, an 87-year-old Portland man, died from fungal meningitis in December 2005.
Scientists in Oregon took 197 samples of air, soil, water, trees and other structures but found nothing. But they knew it had to be here because the victims had not gone to Vancouver Island, said Dr. Paul Cieslak, manager of the communicable diseases program in the state Public Health Division.
"We don't know how long it's been here. The researchers said they don't know whether the samples found outside Vancouver Island means the fungus has colonized other areas, or whether they just represented transient dispersal of the fungus," Bartlett said.
Initial symptoms resemble flu and a general malaise. Only after symptoms continue for several weeks or worsen with a cough that doesn't go away, unexplained weight loss and night sweats do physicians realize they're dealing with something else, she said.
Illness occurs six to nine months after exposure. Once diagnosed, it is very treatable unless it gets to the central nervous system, as happened to the Junction City woman.
She was treated for bacterial meningitis, but wasn't getting better. It wasn't until lab tests came back that Eugene Dr. Robert Barnes figured out she had fungal meningitis.
Doctors say they don't know where she got it.
All told, she spent about four months in the hospital, including stints in the intensive care unit at Sacred Heart Medical Center in Eugene and the Oregon Health & Science University. She went home Dec. 10 and appears to be doing well, her husband said.
She declined to be interviewed.
From a public health perspective, it is more a curiosity than a real threat at this point, said Cieslak, but said he wants to learn where it is in the state and how it works.
"You've got bigger things to worry about," he said. "If we start to get more reports and it's increasing, I'll sit up and take note.