Deadly fungus spread rapidly during pandemic, CDC says
A deadly fungus that is considered an urgent public health threat by the Centers for Disease Control and Prevention spread at an “alarming rate” during the pandemic, the CDC says.
The fungus, called Candida auris, preys primarily on older people 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, showing up most notably in New York and Illinois, where public health officials hoped they could contain it by rigorous screening and infection control in long-term care facilities and nursing homes.
But over the course of 2021, state and local health departments around the country reported 1,474 clinical cases, about a 200 percent increase from the nearly 500 cases in 2019.
The surge represents a “dramatic increase” in caseload and transmission of C. auris, according to a research paper published Monday in the Annals of Internal Medicine and compiled by researchers at the CDC. The fungus is now in half of the 50 states, many with just a handful of cases, but with higher concentrations in California, Nevada, Texas and Florida.
The new paper did not include caseloads from 2022. However, a CDC website that tracks the spread of the fungus shows that there were 2,377 infections reported last year, another sharp increase.
Nearly half of patients who contract C. auris die within 90 days, according to the CDC. But Dr. Meghan Lyman, a medical officer in the mycotic diseases branch of the CDC, said that the agency did not have a good sense of how many deaths to attribute directly to the fungus. The reason is that people who become infected are also dealing with multiple other health challenges, so C. auris can be both a cause of death or something that hastens it.
It is likely that the coronavirus pandemic worsened the spread of C. auris, CDC officials said. With attention focused on Covid-19, less emphasis was put on screening for C. auris. Also, the fungus tends to cling to nursing gowns, gloves and other personal protective gear that were often reused during the pandemic because of supply shortages. C. auris can also attach to ventilators or other medical equipment.
“We were worried what would happen during COVID,” Lyman said. She characterized the spread as “concerning but not surprising.”
C. auris is not a particular threat to young, healthy people, whose immune systems can fight it off, but can be transported on skin and clothing. Those who contract it can experience typical infection symptoms, like fever and chills.
The fungus commonly strikes older patients, particularly those who have many visits or prolonged visits to health care facilities, where it can be hard to clean or eradicate.
C. auris can be resistant to antifungal medications.
During 2020, the research paper found, 86% of the germ samples tested by the CDC’s Antimicrobial Resistance Laboratory Network were resistant to a class of drugs known as Azoles.
More concerning to health officials is that 1.2% of C. auris samples were resistant that year to a frontline treatment class of drugs called echinocandins. If resistance to echinocandins becomes more common, C. auris could become extremely difficult, if not impossible, to treat, health officials said.
Lyman also said that the news is not all bad. Efforts to stop the spread of the germ in New York and Illinois appear to have been effective in containing C. auris.
“It’s not a hopeless situation,” Lyman said.