Minnesota health officials warn of largest US outbreak of TMVII — a sexually transmitted ringworm-like fungal infection
Minnesota health officials confirmed the largest known U.S. outbreak of Trichophyton mentagrophytes genotype VII (TMVII), with more than 30 known or suspected cases in the Twin Cities since July 2025; oral antifungals are typically required for treatment.
Key takeaways
- TMVII is a dermatophyte fungus linked to sexual networks and close skin-to-skin contact; it often requires prescription oral antifungals, not just topical creams.
- More than 30 known or suspected cases have been reported in the Twin Cities metro since July 2025; MDH is conducting enhanced surveillance.
- Lesions commonly appear on the genitals, perianal area, buttocks and thighs and can be misdiagnosed; persistent rashes deserve clinical evaluation.
- Prevention focuses on avoiding contact with unexplained rashes, not sharing towels or bedding, and disinfecting shared surfaces.
What is TMVII and how it spreads
Trichophyton mentagrophytes genotype VII (TMVII) is a genotype of a dermatophyte fungus related to common ringworm, tinea cruris (jock itch) and athlete’s foot. Unlike many superficial fungal infections that respond to over‑the‑counter creams, TMVII has been associated with networks of skin‑to‑skin contact, including sexual activity. It can also spread via shared towels, linens, sex toys, gym equipment and contaminated surfaces in showers and locker rooms.
Sources: CIDRAP (University of Minnesota), Fox News, ABC3340.
Symptoms to watch for
People with TMVII typically report round, red or raised rashes that may be itchy or painful. Lesions most often appear on the genitals, perianal area, buttocks, inner thighs and may also show up on the abdomen, arms, trunk or legs.
“Lesions that do not improve with over‑the‑counter antifungal creams deserve evaluation by a medical provider,” public health officials advise.
Because TMVII rashes can resemble eczema, psoriasis, bacterial infections or routine ringworm, misdiagnosis is possible. In immunocompromised people the infection can spread more widely, cause scarring or lead to secondary bacterial infection.
Outbreak timeline and public health response
The first U.S. TMVII report came from New York in 2024. Minnesota’s first confirmed case occurred in July 2025 in a Twin Cities resident with a genital rash. After additional patients and reported contacts emerged, the Minnesota Department of Health established enhanced surveillance and issued a health alert in February 2026 asking clinicians to test and report suspected cases.
MDH requests that providers obtain skin scrapings for fungal culture to confirm cases and notify public health teams when TMVII is suspected or confirmed.
Read the health alert: Minnesota Department of Health HAN.
Who appears most affected
Reported clusters in the U.S. and abroad have been more common among men who have sex with men, commercial sex workers and people with histories of other sexually transmitted infections. Case interviews in Minnesota suggest sexual contact is a primary driver of transmission in the Twin Cities cluster, though nonsexual skin‑to‑skin spread and fomite transmission remain possible.
Public health officials emphasize that anyone with exposed skin and close contact with an infected person can be at risk.
Diagnosis and treatment
Clinicians are advised to consider TMVII when rashes fail to respond to topical antifungals. Diagnosis is based on clinical exam and confirmation with skin scrapings sent for fungal culture or other laboratory testing.
Treatment: TMVII commonly requires systemic (oral) antifungal medication prescribed by a healthcare provider. Courses can run for several weeks and in some cases up to about 12 weeks depending on severity and response. Current antifungal drugs are reported to remain effective against TMVII, but proper diagnosis and adherence to therapy are essential to clear infection and limit spread.
Prevention steps people can take now
- Avoid skin‑to‑skin contact with anyone who has an unexplained rash, especially on the genitals or buttocks. See guidance from Minnesota Department of Health.
- Do not share towels, bedding, clothing or sex toys. Wash linens in hot water and use high‑heat drying.
- Clean and disinfect shared surfaces in gyms, locker rooms and bathrooms.
- Seek medical care if a rash appears or worsens after home treatment; do not delay, especially if symptoms affect daily life or spread.
Implications for the United States
Economic: Increased clinic visits and prescription use could raise costs for patients and health systems; rural areas may face delays in diagnosis and treatment.
Political and social: State and local health departments may face questions about surveillance, funding and messaging. Stigma can deter care; public messaging should stress that TMVII is treatable and encourage confidential testing and honest partner conversations.
Practical: Rural clinics and small hospitals should be ready to recognize TMVII and refer patients for testing or oral antifungals. Employers and community leaders can help by promoting hygiene, cleaning shared facilities and protecting privacy.
Reporting and sources
This article draws on the Minnesota Department of Health health alert and reporting from national and local outlets. Full source links for reference and further reading:
- Minnesota Department of Health HAN
- Fox News report
- Spanish Fox News (Noticias)
- CBS Minnesota
- CIDRAP (University of Minnesota)
- KSTP local reporting
- ABC3340 coverage
If you notice suspicious rashes or have concerns about exposure, contact your local clinic or primary care provider. Providers are asked to consider TMVII in persistent cases, collect skin scrapings for culture, and notify public health authorities when TMVII is suspected or confirmed (MDH HAN).
