It’s not just “The Last of Us”. Fungal infections are truly a ‘major threat’ to public health, says WHO

The millions of viewers who relaxed and watched HBO’s hit series The last of us are unlikely to think the series is grounded in much of reality.

However, the drama writer championed the premise that the world could be brought to its knees by a simple fungal infection – and it turns out the World Health Organization is worried about that too.

In October 2022, the WHO published the first-ever list of fungal “priority pathogens”, along with a series of stark warnings. The body pointed out that fungal pathogens are becoming both more common and more resistant to treatment, with medical professionals having only four classes of drugs to combat them.

Diseases can be caused by a range of fungi found everywhere, from the great outdoors to indoor surfaces to the inside of the human body. These can develop into a range of health problems including skin infections, lung conditions such as asthma or pneumonia, blood infections, ringworm, meningitis or strains of tuberculosis.

And while many fungal infections are considered minor everyday problems, such as athlete’s foot or yeast infections, other invasive forms pose a major risk to immunocompromised patients or those with serious undercurrent health conditions. underlyings. Experts estimate that about 2 million people die each year from fungal infections.

“Out of the shadows”

As the world was busy battling COVID, fungal infections began to “emerge from the shadows” in more treatment-resistant forms, said Dr Hanan Balkhy, WHO deputy director-general for resistance. to antimicrobials (AMR), in an October press release.

As a result, the organization began making the case for more research and development on these pathogens to establish how dangerous and drug-proof they are.

The WHO stressed when publishing its list of priority fungi that there is currently not enough evidence or knowledge about these pathogens to fully understand the “burden” they may have on public health. .

However, UN agency officials said countries could get a head start on potentially dangerous fungal infections by taking steps such as boosting laboratory capacity and ensuring equitable access. to existing treatments.

Why haven’t we heard of it before?

Fungal infections have long lurked in plain sight and slip through the cracks of public health agencies, experts say Fortune.

“When we think of fungal infections, we think of something a little weird or embarrassing, something insignificant and superficial,” said Dr. Neil Stone, infectious disease specialist and head of fungal infections at the University College London Hospitals, during a phone call. “There’s been a legacy of neglect in looking at these diseases, and it’s taken decades for people to pay attention.”

Besides hiding behind a monotonous headline, these infections are not within the purview of any specific public body to deal with, added David Denning, professor of infectious diseases at the University of Manchester.

Indeed, these diseases span a wide range of practices and are also often misdiagnosed, he said, noting that the number of people contracting and dying from fungal infections is only increasing. The number of cases is increasing due to a range of factors: longer lifespans, climate change, travel and drug resistance.

Drug resistance is a key issue, added UCL’s Stone, because the limited arsenal medical professionals have to fight fungal diseases is often overused in humans and animals.

How soon will this become a problem?

However, there is good news. Stone said the rise in these infections is unlikely to be as “explosive” as the COVID pandemic.

He added that the coronavirus outbreak has proven how quickly the medical community can come together to resolve issues when needed, but noted that developing better diagnostic workflows and expanding a repertoire ” pitiful” of drugs must be top priorities.

Measures to tackle rising fungal infections will continue at varying paces, explained Denning of the University of Manchester, who is also chief executive of Global Action for Fungal Infections (GAFFI).

“There are things we can do quickly that have a big impact,” he said. Fortune. “Rapid diagnostics are one of them. We can teach someone to use a test very easily, and they’re only about $4 each.”

In the long term, training doctors in the field and linking clinical and laboratory engagement is essential, in order to reduce diagnostic errors and establish which groups of patients are most susceptible to which disease, he said. added. From there, data can be more easily collected and shared by public health agencies.

What should the public do?

Being aware that fungal diseases are more than athlete’s foot is a good place to start, experts said.

On top of that, there are a few groups of people who might need to talk to a healthcare professional about their symptoms, Prof Denning added.

“If you’re immunocompromised, maybe you have bad breasts or bad skin, or you’re a woman who suffers from recurring yeast infections, then the next time you go to the doctor instead of getting a cream or a prescription for steroids, ask, ‘Is it a fungal infection?’” he said. “The tests are very similar, they just aren’t done as routinely. There just needs to be a general awareness of these diseases.”

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It’s not just “The Last of Us”. Fungal infections are truly a ‘major threat’ to public health, says WHO

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