Aspergillus and Allergic Bronchopulmonary Aspergillosis (ABPA) in Grand Rapids, MI

Aspergillus is a common type of fungus found both indoors and outdoors throughout West Michigan, including Grand Rapids. It thrives on decaying vegetation such as compost heaps, fallen leaves, and yard debris—materials that are common around Grand Rapids homes, especially in the fall. It can also be found in air-conditioning systems, ventilation ducts, and hospital environments.

For most people, Aspergillus spores do not cause illness. However, in some people with asthma or weakened immune systems, these spores can trigger serious lung problems, including a condition called allergic bronchopulmonary aspergillosis (ABPA).

Residents in Grand Rapids, with its cold winters, damp springs, and leafy neighborhoods, may be exposed to Aspergillus spores in basements, older homes, near the Grand River, and in areas with heavy vegetation or standing water.

How Aspergillus Affects the Lungs

The lungs sit inside the chest, protected by the ribcage and wrapped in a thin membrane called the pleura. Air travels down the windpipe (trachea), which splits into two bronchi, one for each lung. These bronchi divide into smaller tubes called bronchioles, which lead to tiny air sacs called alveoli.

Each alveolus is surrounded by a fine mesh of tiny blood vessels called capillaries. This is where oxygen enters the blood and carbon dioxide is removed. In asthma and ABPA:

  • The bronchioles can spasm and narrow
  • The airways can become inflamed and filled with mucus
  • Breathing becomes difficult, causing wheezing and shortness of breath

In Grand Rapids, where cold, dry winter air and indoor heating can already irritate the airways, exposure to Aspergillus spores can further worsen breathing problems in people with asthma.

Aspergillus, Allergens, and Asthma in Grand Rapids

An allergen is any substance that triggers an exaggerated response from the immune system, even though the substance itself is not poisonous. For people with asthma, common allergens and irritants in West Michigan include:

  • Cigarette smoke and wood smoke (including from fireplaces and wood stoves used in winter)
  • Pollen from trees, grasses, and weeds (especially in spring and summer)
  • Dust mites in older or poorly ventilated homes
  • Mold and fungal spores, including Aspergillus, in damp basements, bathrooms, and around the Great Lakes region
  • Outdoor mold on rotting leaves, compost piles, and yard waste

About nine out of ten people with asthma notice their symptoms worsen when exposed to triggers like these. Men and women with asthma between 20 and 40 years of age are most commonly affected by ABPA, but it can occur at other ages as well.

People with cystic fibrosis, which is managed at major centers such as Spectrum Health and other regional hospitals, are also particularly vulnerable to Aspergillus-related lung disease.

What Is Allergic Bronchopulmonary Aspergillosis (ABPA)?

Allergic bronchopulmonary aspergillosis (ABPA) is a condition in which the immune system overreacts to Aspergillus spores in the lungs. This causes:

  • Significant worsening of asthma
  • Increased inflammation in the airways
  • Excess mucus production
  • Potential long-term damage to the lungs if not treated

ABPA is more likely in people who:

  • Have asthma or cystic fibrosis
  • Are immunocompromised (for example, those receiving chemotherapy, organ transplant medications, or long-term high-dose steroids)
  • Have other serious illnesses and are hospitalized, including in Grand Rapids facilities such as Spectrum Health, Trinity Health Grand Rapids, or Metro Health

Symptoms of ABPA

If you live in Grand Rapids and have asthma or cystic fibrosis, be alert for the following symptoms of ABPA:

  • Wheezing
  • Breathlessness or shortness of breath
  • Significant worsening of usual asthma symptoms
  • A productive cough with brown mucus or mucus plugs
  • Coughing up blood (haemoptysis)
  • Fever
  • Loss of appetite
  • General malaise (feeling unwell, tired, or run down)

These symptoms can be mistaken for a regular asthma flare or infection, so it is important to see a healthcare provider familiar with ABPA if these signs persist or worsen.

Complications of Untreated ABPA

Without proper treatment, ABPA can lead to serious lung complications, including:

  • Haemoptysis – bleeding from the irritated, inflamed airways
  • Bronchiectasis – permanent widening and damage of the airways, leading to chronic cough and recurrent infections
  • Atelectasis – collapse of part of the lung
  • Respiratory failure – the lungs cannot provide enough oxygen to the body

This is a medical emergency

If you cough up blood, have severe shortness of breath, or sudden chest pain, seek emergency care immediately at your nearest Grand Rapids emergency department (e.g., Spectrum Health Butterworth Hospital, Trinity Health Grand Rapids, or another local ER) or call 911.

How ABPA Is Diagnosed

Diagnosis of ABPA usually involves several tests. In Grand Rapids, these tests are available through local hospitals, pulmonary clinics, and allergy specialists.

1. Chest Imaging

  • Chest X-ray – looks for fluid in the lungs and for abnormalities such as enlarged, stretched, or damaged airways
  • CT scan of the chest – provides more detailed images to assess bronchiectasis and other structural changes

2. Skin Testing

A skin prick test may be done:

  • A small amount of Aspergillus allergen is placed on or just under the skin
  • If you are allergic, you may experience swelling, redness, and itching at the site, usually within about 20 minutes
  • In some people, the reaction may take up to eight hours to fully develop

3. Blood Tests

Blood tests may include:

  • Aspergillus-specific antibodies – the immune system makes special proteins (antibodies) against Aspergillus
  • Precipitins – antibodies that bind to Aspergillus spores and form tiny solid complexes, which can be measured
  • Immunoglobulin E (IgE) levels – around half of all people with ABPA have elevated IgE, a type of blood protein that is associated with allergic reactions

4. Sputum (Mucus) Tests

  • A sample of your mucus (sputum) is examined under a microscope
  • Aspergillus spores may be visible
  • The spores can be cultured and identified using special dyes to confirm the presence of Aspergillus

Your primary care provider or asthma specialist in Grand Rapids may refer you to a pulmonologist or allergist for these tests, often available through Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health clinics.

Treatment for ABPA

There is currently no cure for ABPA, but the condition can be effectively managed. Treatment focuses on reducing inflammation, controlling symptoms, and preventing lung damage.

Main Treatment Options

  1. Corticosteroids

    • Usually taken orally (pill or liquid)
    • Sometimes used in inhaled form (puffers) to help control asthma symptoms
    • Help reduce inflammation in the airways and improve breathing

  2. Antifungal Medications

    • In many cases, antifungal medications have limited effect on ABPA itself
    • They may sometimes be used to reduce fungal load in the lungs, but steroids remain the primary treatment

  3. Asthma Management

    • Regular use of prescribed inhalers (preventers and relievers)
    • Asthma action plan tailored by your Grand Rapids healthcare provider
    • Monitoring peak flow or lung function at home, especially during high-risk seasons (fall leaf mold, spring pollen, and winter indoor heating)

Ongoing Monitoring and Follow-Up

People with ABPA should be monitored regularly to ensure that their condition is well controlled. Follow-up care in Grand Rapids may include:

  • Regular visits with your primary care provider, pulmonologist, or allergist
  • Periodic blood tests to check antibody and IgE levels
  • Lung function tests to evaluate airflow and measure how well your lungs are working
  • Repeat chest imaging if symptoms change or worsen

Close monitoring helps your care team adjust medications and prevent long-term lung damage.

Reducing Exposure to Aspergillus in Grand Rapids

While Aspergillus is a particularly common fungus and cannot be completely avoided, people with ABPA or Aspergillus-sensitive asthma can take steps to reduce exposure, especially around Grand Rapids:

Outdoor Tips

  • Avoid spending long periods around:
    • Marshes and boggy areas
    • Forested areas with heavy leaf litter
    • Compost heaps, mulch piles, and rotting vegetation
  • Use a mask when:
    • Raking leaves in the fall
    • Working with compost or mulch in your yard or garden
    • Cleaning up damp basements or garages

Indoor Tips

  • Keep basements and bathrooms dry using dehumidifiers, especially during humid Michigan summers
  • Regularly clean and maintain:
    • Air-conditioning and HVAC systems
    • Furnace filters and vents
  • Address water leaks and mold growth promptly in older Grand Rapids homes
  • Avoid smoking indoors and limit exposure to wood smoke, especially in winter

For guidance on mold and indoor air quality, local resources such as the Kent County Health Department and Grand Rapids Public Health can provide information and referrals.

When to Seek Help in Grand Rapids, MI

Contact a healthcare provider if you:

  • Have asthma or cystic fibrosis and notice your symptoms are getting worse
  • Develop a new or persistent cough with brown mucus
  • Experience frequent wheezing or shortness of breath
  • Have repeated “chest infections” that do not fully clear

If you are in the Grand Rapids area, you can seek care from:

  • Your GP (primary care doctor)
  • Asthma and lung clinics at:
    • Spectrum Health
    • Trinity Health Grand Rapids
    • Metro Health
    • Mercy Health
  • Local public health resources:
    • Kent County Health Department
    • Grand Rapids Public Health programs

In an emergency—such as severe breathing difficulty, chest pain, or coughing up significant amounts of blood—call 911 or go to the nearest emergency department.

Key Points About Aspergillus and ABPA in Grand Rapids

  • Aspergillus is a common fungus that grows on decaying vegetation, such as compost heaps and fallen leaves, and in damp indoor areas throughout West Michigan.
  • People with asthma who are allergic to Aspergillus may have spasms of the bronchioles, causing breathlessness and wheezing.
  • Nine out of ten people with asthma find their symptoms worsen when exposed to triggers or allergens like smoke, pollen, dust mites, and fungal spores.
  • Men and women with asthma aged 20 to 40 years are most commonly affected by ABPA, and people with cystic fibrosis are also at high risk.
  • Treatment options include corticosteroid medications, careful asthma management, and avoiding exposure to Aspergillus as much as possible.
  • Regular monitoring and early treatment by Grand Rapids healthcare providers can help prevent serious complications and protect long-term lung health.