Fungi posing bigger health risks, as drugs’ potency wanes, experts warn
People around the planet must be more wary of the fungus among us, because the too often overlooked pathogens are becoming “increasingly widespread, resistant to treatment, and deadly.”
That’s the view of the World Health Organization, as reported by the New York Times and other media organizations. WHO has sought to heighten awareness about an array of fungal infections because fewer of them can be treated well with familiar therapeutics, the newspaper reported:
“The health agency listed 19 invasive fungal diseases, including four it described as a ‘critical priority,’ that collectively kill 1.3 million people and contribute to the death of five million others each year. Many of those deaths occur among people with HIV, cancer, tuberculosis, and other underlying health conditions that leave them vulnerable to infection. Health officials say the death toll from fungal infections is likely much higher because many hospitals and clinics, especially in poorer countries, lack the diagnostic tools for detecting them. ‘The bottom line is that invasive fungal infections are becoming more prevalent, but frequently they are not recognized in patients and not correctly treated,’ Dr. Carmem L. Pessoa-Silva, a WHO official focused on disease surveillance and control, said at a news conference …’We do not have a real sense of the size of the problem.’”
The newspaper reported on several rising fungal infections of major concern to health officials, including:
- “Mucormycosis [is] a rare but aggressive pathogen often referred to as ‘the black fungus. [It] has stalked thousands of Covid patients, some of whom have required disfiguring facial surgeries to remove the infections
- “Aspergillus fumigatus, a common mold that can be fatal to those with weakened immunities, have been tied to the prodigious use of fungicides on cash crops like grapes, corn and cotton
- “And Candida auris, one of the four ‘critical priority’ fungi cited in the WHO. report. The fungus (shown above), a yeast first identified in Japan in 2009, has spread to four dozen countries and is often resistant to more than one drug
Just a reminder, the newspaper in 2019 published a chilling, detailed report on the scary U.S. spread of C. auris, including the giant difficulties in eradicating the fungus once it establishes itself in hospitals, nursing homes, and other medical facilities.
Big threats, diminishing responses
Fungal infections can pose big threats to patients’ health, the New York Times reported:
“Once a fungal infection enters the bloodstream, treatment becomes exponentially more difficult: Bloodstream infections with fungi in the candida family, for example, have a mortality rate of 30%.”
This menace has become even more of a worry for known causes, notably that for many fungal infections, the effective treatment drugs have dwindled to as few as four, the newspaper reported:
“Much like pernicious bacteria that evolve and become resistant to antibiotics through their overuse in people and agriculture, antifungal medications have been losing their curative punch in recent years.”
The federal Centers for Disease Control and Prevention has sounded the alarm about antimicrobial resistance — the relentless increase in so-called super bugs — and its ties to the coronavirus pandemic, as well as longstanding problems with the widespread use and abuse of life changing and lifesaving antibiotics. As the agency has reported on its website:
“The U.S. lost progress combating antimicrobial resistance in 2020 due, in large part, to effects of the Covid-19 pandemic. The CDC Covid-19: U.S. Impact on Antimicrobial Resistance, Special Report 2022 … concluded that the threat of antimicrobial-resistant infections is not only still present but has gotten worse. During the first year of the pandemic, more than 29,400 people died from antimicrobial-resistant infections commonly associated with health care. Of these, nearly 40% of the people got the infection while they were in the hospital. The total national burden of deaths from antimicrobial resistance may be much higher, but data gaps caused by the pandemic hinder that analysis.”
In 2019, the CDC described the severity of resistance and the prevalence of super bugs and their deadly results, with the agency reporting then that one American dies every 15 minutes due to this problem, which has so degraded the effectiveness of common treatments that this country effectively has entered a risky “post-antibiotic” era.”
Not good. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the common sense in their working to stay healthy and out of the U.S. health care system. That system not only is costly and inconvenient, it is fraught with medical error, hospital infections and deaths, and misdiagnoses.
Remedial steps for a rising worry
Quashing superbug outbreaks may be one of several steps to deal with antibiotic resistance, experts say. They also have urged doctors and patients to halt the indiscriminate use of the drugs, with prescriptions, for example, for common colds or ear infections whose viral causes aren’t helped by antibiotics. Individuals can help reduce infections’ risks by staying healthy, eating well, getting enough exercise and sleep, controlling their weight and alcohol use, and not smoking. They also should consider keeping their vaccinations up to date, including for the flu.
Big Agriculture also must be discouraged from abusive antibiotic use on crops and with livestock to increase yields. Major food customers — including fast food and restaurant chains and schools and governments — can encourage their suppliers to forgo wasteful and unnecessary antibiotic use.
Big Pharma could play a beneficial role in developing and selling bug fighting drugs at reasonable costs. Profit-ravenous makers, however, have deigned to tackle a global need that would serve humanity — because the returns would be too low, and the risks would be high. Nonprofits and health agencies may need to step in on a global basis to address this and other looming crises with pharmaceuticals.
Experts at the RAND Corporation have estimated that unchecked antibiotic resistance could reduce the global population by up to 444 million people and that could contribute to global economic losses as high as $124.5 trillion.
We have much work to do to halt inappropriate uses of bug-killing drugs, to develop new ones, and to eradicate fungal, bacterial, and viral threats to our health.