Minnesota is seeing the largest outbreak of sexually transmitted ringworm in the U.S., with infections disproportionately affecting men who have sex with men.
More than 30 confirmed or suspected cases of the fungal infection have been reported in the state since last July, according to the Minnesota Department of Health, and all were within the Twin Cities metropolitan area.
The ringworm - known as trichophyton mentagrophytes genotype VII, or “TMVII” - was first reported in New York City in June 2024.
Minnesota’s Health Department said that the Centers for Disease Control and Prevention is aware of other sporadic cases in larger cities across the U.S.
California’s Department of Public Health previously said the first patient with TMVII had traveled to California before he was diagnosed in New York.
TMVII has been circulating in Europe and among people who traveled to Southeast Asia for sex tourism for several years, but is not currently considered widespread in the U.S.
A coin-like rash
TMVII is the only known sexually transmitted fungal infection, according to the Cleveland Clinic.
Sometimes confused for eczema or psoriasis, TMVII spreads through skin-to-skin contact or exposure to fungal spores. The ringworm can spread through genital contact, as well as to the face, bottom, torso, arms and legs.
It can cause painful and itchy red, coin-like rashes, sometimes with bumps or pimples on top.
Infections can vary in severity, sometimes leading to complications even with treatment.
Patients may see lesions and open sores that increase the risk for secondary bacterial infections and lead to harmful inflammation.
“Some patients might develop painful and persistent rashes that can lead to scarring or worsening infections that need to be treated with antibiotics,” health officials warned last month.
A lengthy treatment process
Diagnosing TMVII infection requires advanced testing, although most labs have trouble distinguishing TMVII from two other fungal infections known as T. mentagrophytes and T. interdigitale, according to the CDC.
Patients may require weeks or even months of oral medication, and people should avoid using steroid creams, as they will worsen TMVII infection.
To prevent exposure, people should avoid sexual contact if they or their partner has a new rash and avoid sharing personal items, such as clothing, towels, bedding and razors.
Items should be washed and dried on high heat, and fungal spores can be killed with common disinfectants or strong detergents.
People who believe they have a rash should make sure it is covered with bandages or clothing and wash their hands with soap after touching the infected area to reduce the risk of spread to other areas of the body.
“While the overall public health risk is low, state health officials say MSM, people who use anonymous apps, and people with a history of sexually transmitted infections may be at higher risk,” according to the University of Minnesota’s Center for Infectious Disease Research and Policy.
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