Threat from fungal infections on the rise, concerned experts say

Scientists are expressing concern about the increasing threat by disease-causing (pathogenic) fungi. Fungal infections are called mycoses. Experts are sounding the alarm in light of four major factors.

1. Climate change is causing the geographic spread of pathogenic fungi.

2. The COVID-19 pandemic has weakened the immune systems of many people making them vulnerable to opportunistic fungal infections.

3. There are increasing numbers of persons with weakened immune system owing to HIV, immune suppressing drugs used after transplants and during the treatment of cancers.

4. Doctors have very few treatment options against fungal infections.

Fungal infections — spread by spores — are classified according to the part of the body affected. Superficial fungal infections include athlete’s foot and ringworm. Such infections may not be life threatening. However, if fungal spores are inhaled, systemic infection can occur. One increasingly common systemic infection is fungal pneumonia which is difficult to treat and is often fatal.

Dr. Matthew Fisher is a professor of medicine in the School of Public Health at Imperial College London; he researches emerging pathogenic fungi.

Regarding the climate change factor Dr. Fisher said, “The world is becoming warmer and wetter. That’s just going to mean that there’s a higher burden of mold spores.”

Speaking of the impact of the pandemic, Dr. George Thompson, professor of clinical medicine at the University of California, Davis, and cochair of the University of Alabama–based Mycoses Study Group Education Committee said, “We had predicted [a rise in] aspergillosis, but we saw more than we thought we’d see. Most fungal infections became more common with COVID-19. Pneumocystitis, for instance, has historically been associated with AIDS or different types of leukemia or lymphoma, and is not an infection we’ve typically seen in our otherwise healthy patients,” he noted. “But we did see more of it [with COVID-19].”

Dr Hanan Balkhy, World Health Organisation (WHO) Assistant Director-General, Antimicrobial Resistance (AMR) said that, “Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing, and are ever more resistant to treatments, becoming a public health concern worldwide.”

The limited treatment options is the other cause of concern. Experts say that there are only four types of drugs to treat fungal infections. Further, pathogenic fungi are becoming increasingly resistant to treatments because of careless human activity.

A WHO report says, “Resistance to antifungal medicines is partly driven by inappropriate antifungal use across the spectrum. For example, injudicious use of antifungals in agriculture was linked to the rising rates of resistant Aspergillus fumigatus infections.”

The WHO report recommends that “Countries [should] follow a stepwise approach, starting with strengthening their fungal disease laboratory and surveillance capacities, and ensuring equitable access to existing quality therapeutics and diagnostics, globally.”