Minnesota health officials warn of TMVII outbreak — a sexually transmitted fungal infection causing severe ringworm
Minnesota health officials are warning residents after more than 30 confirmed or suspected cases of TMVII, a sexually transmitted Trichophyton mentagrophytes genotype VII fungal infection that causes severe ringworm, were reported in the Twin Cities since July 2025.
- Largest known U.S. outbreak: Over 30 confirmed or suspected TMVII cases reported in the Twin Cities since July 2025, according to state reporting and news coverage (CBS News; KSTP).
- Sexually transmitted fungus: TMVII is a genotype of Trichophyton mentagrophytes that spreads primarily via sexual and close skin contact, unlike many common environmental fungal infections (CBS News; Fox News).
- Longer treatment needed: Typical management requires oral antifungal medication for up to 12 weeks — far longer than many topical-treated ringworm cases (CBS News; Fox News).
What is TMVII?
TMVII is a genotype of the fungus Trichophyton mentagrophytes, organisms that commonly cause superficial skin infections such as ringworm, athlete’s foot and jock itch. TMVII stands out because it spreads mainly through sexual and close skin-to-skin contact, rather than primarily via shared surfaces in homes or gyms (CBS News; Fox News).
Earliest U.S. reports: The first U.S. case was reported in New York City in June 2024, and Minnesota confirmed its first local case in July 2025 after a patient presented with a genital rash. State officials report 13 laboratory-confirmed cases and 27 suspected cases in the Twin Cities area, totaling more than 30 confirmed or suspected infections (KSTP; CBS News; Fox News).
Signs, symptoms and why TMVII can be missed
The hallmark presentation is a round or coin-shaped red rash. Lesions may have surface bumps or pimples and appear on the arms, trunk, legs, buttocks, genitals, perianal area and thighs. They can be itchy or painful and may persist if not treated (CBS News; ABC3340).
Because TMVII rashes can resemble eczema, psoriasis or other dermatologic conditions, clinicians may not immediately suspect a fungal sexually transmitted cause. Reports note that lesions sometimes do not respond to over-the-counter topical antifungals — a potential clue that oral, prolonged therapy is needed (Fox News; KSTP).
Who is most at risk?
Minnesota reporting indicates TMVII has been most common among men who have sex with men and commercial sex workers in this outbreak, although anyone can become infected through close skin contact. A history of prior sexually transmitted infections may increase susceptibility (CBS News; Fox News).
Diagnosis, treatment and follow-up
Diagnosis usually begins with a clinical exam; providers may take skin scrapings for fungal culture or genotyping. Minnesota health officials have requested that providers submit fungal isolates to the state public health laboratory for confirmatory testing as part of enhanced surveillance (CIDRAP).
Treatment: Most cases require prescription oral antifungal drugs. Unlike common ringworm that often clears with topical creams, TMVII has required prolonged courses — up to 12 weeks in many patients. Untreated or delayed care can lead to scarring or progression in immunocompromised people (CBS News; Fox News).
Follow-up and public health: Providers are being asked to report suspected cases and send samples for laboratory confirmation to aid contact tracing and surveillance (CIDRAP).
Public health response in Minnesota
The Minnesota Department of Health (MDH) established enhanced surveillance after clinicians and patients identified clusters and possible exposure networks. Officials advise informing recent sexual partners, avoiding skin-to-skin contact until treatment is complete, not sharing clothing, towels or bedding with infected persons, and washing linens/towels in hot water (Fox News; CBS News).
Expert observations
Dr. Hayden Andrews, an infectious disease specialist at UT Southwestern Medical Center, noted that TMVII symptoms often resemble typical ringworm or jock itch and can be mistaken for eczema. He emphasized clinicians should consider TMVII when rashes fail to respond to standard treatments (Fox News).
Implications for the world
Economic impact
Extended treatment courses and increased testing can strain health systems and individual finances. If TMVII spreads internationally, clinics and sexual health services may need to reallocate resources for testing, longer treatments and public messaging.
Political consequences
Outbreak responses often influence policy debates on sexual health funding, surveillance priorities and prevention. Authorities may face pressure to expand testing, strengthen sexual health education, and ensure affordable access to antifungal medications — communicating in ways that avoid stigma.
Social effects
Because TMVII is sexually transmissible, stigma could deter people from seeking care or notifying partners, which would hinder control efforts. Clear, factual, nonjudgmental public messaging is crucial to encourage testing, treatment and partner notification.
Cultural relevance
Different cultural norms around sexual health require tailored, confidential, and language-appropriate approaches — for example, anonymous partner notification tools and multilingual education describing symptoms and treatment plainly.
Practical applications for health systems and the public
- Clinicians: Consider TMVII for round, itchy rashes that do not improve with topical antifungals and, where possible, submit samples to public health laboratories for confirmation (CIDRAP).
- Individuals: Seek medical care if you have suspicious rashes, avoid sexual and other skin-to-skin contact until cleared, and inform recent partners so they can be evaluated and treated if necessary (CBS News).
- Public health programs: Prepare to expand surveillance, testing, and supply of oral antifungal drugs for longer treatment courses (Fox News).
