Fungal disease increased during the Covid pandemic and the spread of pathogens due to the climate crisis, WHO says

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Health-threatening fungi are spreading to the geographic area due to climate change, while some fungal diseases increased during the Covid-19 pandemic, according to the authors of a recently published World Health Organization report.

On Tuesday, WHO released its first-ever list of priority fungal pathogens, cataloging 19 organisms that experts have identified as the greatest threat to public health.

“Currently, fungal infections receive less than 1.5% of all infectious disease research funding,” the report found, suggesting that the true health burden of fungi is unknown, while “most of the guidelines for treatment they are informed by limited evidence and expert opinion. “

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WHO Deputy Director-General for Antimicrobial Resistance, Dr Hanan Balkhy, said in a statement: “Emerging from the shadow of the bacterial antimicrobial resistance pandemic, invasive fungal diseases are becoming increasingly resistant to treatments, becoming an ever-increasing concern. most urgent for public health around the world. “

Dr Justin Beardsley, of the University of Sydney’s Institute of Infectious Diseases, who led a WHO-commissioned group, said the underestimation of historical research was not keeping up with the “enormous disease burden” of fungal infections.

“They are causing as many deaths as tuberculosis, and more than malaria,” he said.

The report, which involved more than 400 mycology experts and a review of more than 6,000 research papers, classified fungal pathogens based on public health impact and risk of resistance to antifungal drugs.

Of the 19 mushrooms included, four were identified as “critical” priorities. These included Aspergillus fumigatus And candida albicans – the two most common fungal pathogens globally – as well Cryptococcus neoformanswhich is a leading cause of death in people with HIV.

Aspergillus fumigatus mainly affects the lungs, while candida albicans it is the most common cause of thrush, and invasive infections in vulnerable patients have high mortality rates.

Infection rates of both pathogens increased in many countries during the Covid-19 pandemic. “Suddenly we had a group of patients who were really getting sick, having lung damage, being in intensive care and taking immunosuppressive drugs, and so we saw a spike in the rates of these infections,” Beardsley said.

Aspergillus fumigatus has its own disease state called Covid-associated pulmonary aspergillosis.

The fourth critical priority pathogen, Candida auris, it grows like yeast and was first discovered in humans in 2009.

“It just didn’t exist before then,” Beardsley said.

“It literally appeared all over the world at the same time and we’re still trying to figure out why and how.”

The pathogen is “inherently resistant to most antifungal drugs available” and has “a high potential for outbreak,” the report found.

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The researchers also noted the geographic spread of fungal pathogens that were previously limited to certain regions.

Cryptococcus gatiifor example, it spread from subtropics to temperate regions. Talaromyces marneffei it was thought to be limited to Southeast Asia, but has been found further north in China.

“This may be partly due to it being sought out, but I think it’s more that it’s really expanding its range – and that’s probably related to climate change,” Beardsley said.

Tackling invasive fungal diseases will require more funding for new antifungals and better diagnostics, the report found.

There are only four classes of antifungals currently available, and developing new drugs has been difficult due to the similarities between fungal and mammalian cells, Beardsley said.

“Something that will kill a fungus will often kill a human cell as well,” he said.

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