There are plenty of good reasons to stay out of Minnesota in February….ice, snow, anti-ICE protests, Somali fraudsters, and the occasional moose taking up an entire highway lane.
But this year, locals have added one more to the list: a fungal infection known as TMVII, currently turning the Twin Cities into ground zero for the nation’s largest known outbreak of a sexually transmitted skin fungus. Health officials are calling this sexually transmitted ringworm infection “serious but treatable.”
Minnesota is in the midst of what state health officials call the nation’s “largest known outbreak” of TMVII, a sexually transmitted fungal skin infection that can cause severe ringworm.TMVII, or trichophyton mentagrophytes genotype VII, is the only known fungal-based sexually transmitted disease, according to the Minnesota Department of Health, and it’s treatable with oral antifungals.The first case was reported in New York City in 2024, according to the Centers for Disease Control and Prevention, with Minnesota’s first reported case in July 2025, when a patient sought treatment for a genital rash.
The infection is transmissible via skin-to-skin contact while experiencing symptoms or in the presence of a suggestive rash. Therefore, longtime Legal Insurrection readers who have been following my reports on infectious diseases will not be surprised by what population is most at risk of infection.
The U.S. Centers for Disease Control describes the infection as “an emerging fungus” that was originally “described in travelers returning from Thailand after sexual contact with sex workers.” It’s since been documented in China and in Europe, and is primarily associated with men who have sex with men.Those who are infected are urged to avoid sexual contact, sharing personal items or clothing — and to wash and dry their clothing on high heat, which can kill the spores that may be in the fabric. The Minnesota health department advises that the rash — which is round and sometimes covered with pimples or bumps — can be mistaken for other skin conditions, such as eczema, or psoriasis.
Fungal infections can be challenging to treat. Infection with TMVII usually requires a course of antifungal agents over several weeks.
MDH advised clinicians to confirm dermatophyte infection with potassium hydroxide (KOH) microscopy when available, obtain skin scrapings or biopsies for fungal culture, and send isolates for genotyping to identify TMVII, with the MDH Public Health Laboratory available for confirmatory testing.Clinicians should begin to treat patients with oral terbinafine 250 mg daily for suspected TMVII without waiting for confirmatory testing and continue therapy until two weeks after symptom resolution, with typical courses lasting six to eight weeks and up to 12 weeks in some cases.Topical antifungals may be adjunctive for small lesions, and topical corticosteroids should be avoided because they can worsen TMVII, MDH said.
TMVII is probably not the next pandemic, despite the media drama. The fungus is treatable, and public health officials appear to be moving quickly to contain it before it spreads beyond current clusters.
Still, the outbreak underscores a truly many are keen to ignore, “life will find a way”. Fungi are adapting, and human behavior and global travel are helping them find new niches. Coverage that minimizes the nature of how this fungus is spread does nobody any favors.
So, while Minnesota’s residents are no strangers to icy roads and winter hazards, this year’s hottest health story is a reminder that the cold isn’t always the worst thing you can catch in February.
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