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Deadly fungus spreading rapidly during pandemic, says CDC

Written by Matt Richtel

A deadly fungus that the Centers for Disease Control and Prevention considers an urgent public health threat is spreading at “alarming speed” during the pandemic, the CDC said Monday.

The fungus, known as Candida auris, preys on older adults with weakened immune systems and is particularly dangerous because it resists treatment with common antifungal medications. C. auris was first reported in the United States in 2016, most notably in New York and Illinois, where public health officials hope they can keep it under control through rigorous screening and infection control in long-term care facilities and nursing homes.

But during 2021, state and local health departments across the country reported 1,474 clinical cases, an increase of about 200% from nearly 500 in 2019.

The surge represents a “dramatic increase” in the number of cases and transmission of C. auris, according to a research paper published Monday in the Annals of Medicine and compiled by researchers at the US Centers for Disease Control and Prevention (CDC). The fungus is now found in half of the 50 states, many with only a few cases, but in higher concentrations in California, Nevada, Texas and Florida.

The new paper does not include case numbers from 2022 onwards. But the CDC website, which tracks the spread of the fungus, reported another sharp increase last year, with 2,377 infections reported.

According to the CDC, nearly half of patients infected with C. auris die within 90 days. But Dr. Megan Lyman, a medical officer in the CDC’s division of fungal diseases, said the agency doesn’t know how many deaths are directly attributable to the fungus. The reason is that infected people also face multiple other health challenges, so Candida auris can either be a cause of death or hasten it along with other adverse health factors.

Very likely coronavirus CDC officials say the pandemic has exacerbated the spread of Candida auris.focus on Coronavirus disease, with less emphasis on screening for C. auris. In addition, the fungus tends to cling to nursing gowns, gloves and other personal protective equipment that would be changed frequently under ideal conditions but reused during the pandemic due to supply shortages. C. auris can also be attached to a ventilator or other medical equipment

“We worry about what’s going to happen during COVID,” Lehman said. She described the spread as “worrying but not surprising”.

C. auris is not a particular threat to young, healthy people whose immune systems fight it off, but can be spread through the skin and clothing. People who catch it can experience typical infection symptoms, such as fever and chills, that can be exacerbated by lack of treatment. The fungus often attacks older patients, especially those who frequent or chronically visit healthcare facilities, where it can be difficult to clean or eradicate the fungus.

The challenge with treating Candida auris is that it can resist antifungal medications. The research paper found that during 2020, 86 percent of bacterial samples tested by the CDC’s Antimicrobial Resistance Laboratory Network were resistant to a class of drugs called azoles.

Even more worrying for health officials, 1.2 percent of C. auris samples that year were resistant to a class of first-line treatments called echinocandins. If resistance to echinocandins becomes more common as the bacteria evolve, it will become extremely difficult, if not impossible, to treat, health officials say.

Lehmann also said the news wasn’t all bad. Massive efforts to stem the spread of the germ in New York and Illinois appear to be effective in containing Candida auris in those states’ health care systems — even as the bug takes hold elsewhere.

“This is not a hopeless situation,” Lehman said.

This article originally appeared in The New York Times.

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