An influential medical panel in the US warns of the dangers of a rapidly spreading deadly fungus – just a week after the popular zombie show The Last of Us ended.
The American College of Physicians (ACAP) said the emergence and spread of antibiotic-resistant cases of Candida auris, also known as C auris, is “particularly concerning.”
The Centers for Disease Control and Prevention (CDC) described the fungus, which infects up to 60 percent of people with it, as an “urgent threat” in 2019.
A person becomes infected after coming into direct contact with an infected object. It spreads from person to person through direct contact between them. Strict hand washing, especially in hospital settings, can prevent spread.
But the CDC’s new research has revealed that the number of cases across America will more than triple between 2020 and 2021, with antibiotic-resistant strains also becoming more prevalent.
The number of clinical and screening cases of C auris reported to the CDC between 2013 and 2021
The distribution of Cauris cases in the US as reported to the CDC between 2013 and 2021
Most transmission occurs in healthcare facilities, especially among residents of long-term care facilities or those with indwelling devices or mechanical ventilators.
The report, published Monday in the journal Annals of Internal Medicinestudies the fungus that has received a lot of attention in recent months.
There’s been more focus on fungal infections because of the popular HBO show “The Last of Us,” which involved cordyceps that evolved to infect humans, control their minds, and turn them into bloodthirsty zombies who watch vines explode from their bodies and can infect others.
The World Health Organization warns that fungal infections are becoming a ‘major threat’ to public health.
Some experts argue that molds are becoming more common worldwide as the changing climate makes environments more suitable for them.
The latest study looked at confirmed and probable cases reported to state and local health departments and the CDC between 2016 and 2021.
Researchers found that the number of infections rose from 1,310 in 2020 to 4,041 in 2021.
CDC data shows that fungal infections have already caused 7,000 deaths in the US — and 1.5 million worldwide — by 2021.
And the latest data shows that the increase in C auris cases is not stopping, with 2,377 clinical cases and 5,754 screening cases last year.
The study also found that the number of cases of the fungus resistant to the antibiotic echinocandin had also risen – in 2021 there were about three times as many cases as in each of the previous two years.
Candida caused 1,769 deaths in 2021, the largest number of all fungal infections in the US. Aspergillosis caused 1,236 deaths, while Pneumocytis was responsible for 449
Fungal infections were responsible for more than 75,000 hospitalizations in the US in 2021. Candida caused the majority of those, leading to the hospitalization of more than 26,000 people. The second most common were also targeted by the Georgia vaccine, Aspergillosis, responsible for nearly 15,000, and Pneumocytis, which accounted for just over 10,000
Antifungal drug echinocandin is the first line of therapy given to treat C auris.
The fungus was first reported in the US in 2016.
Three years later, the CDC gave the fungus its highest level of concern because it is often multidrug resistant, easily transmitted in healthcare settings and can cause serious infections with high mortality rates.
The main symptoms are fever and chills that do not improve. The fungus can cause many different types of infections, such as in the bloodstream, wounds, or ears.
The death rate depends on the state, but ranges from 30 to 60 percent.
It is spread through direct contact and can also be transmitted through contact with contaminated surfaces or equipment.
People get the fungus through physical contact with an infected person.
The fungus kills more than one in three people with invasive C auris (where the fungus has caused an infection affecting the blood, heart or brain).
The researchers looked at clinical and screening cases. Because screening is not performed uniformly in the United States, the number of C auris cases may be underestimated, they said.
Many of the early cases of Cauris in the US were imported from abroad, with most cases in recent years due to local transmission.
New York City and Chicago were the hardest hit, but cases of the fungus have now occurred in more than half of the US states.
Most of the spread of cases has been in long-term care hospitals and nursing homes.
Patients who are already ill and have multiple conditions, or who are on a ventilator, are at greatest risk.
Between 2019 and 2021, a total of 3,270 clinical cases and 7,413 screening cases were registered.
Prior to that, cases rose from 53 in 2016 to 330 in 2018 and then 44 percent to 475 in 2019.
The number of clinical cases continued to increase each year, reaching 756 in 2020 and then almost doubling to 1471 in 2021.
The number of screening cases also increased – essentially tripling from 1,310 in 2020 to 4,041 in 2021.
Three states – Oregon, Minnesota and Michigan – all reported their first case of the fungus in 2021. Meanwhile, areas with previous cases of limited spread, such as California, Texas and Florida, had new and increasing transmission.
The researchers said the growth in Cauris cases reflects “deficiencies in the early identification of cases and the implementation of infection prevention and control measures.”
They added that the increased spread may have been “exacerbated by pandemic pressures on healthcare and public health systems.”
The findings “underline the need for improved detection and infection control practices to prevent the spread of C auris,” the study authors wrote.