The US Centers for Disease Control and Prevention (CDC) issued an alert on Monday (20/3) about the spread at an alarming rate of the fungus candida auris during the Covid-19 pandemic. The fungus is considered by the authorities to be an “urgent threat”.
A study by the American body, published on the same day in the scientific journal Annals of Internal Medicineshows that cases skyrocketed in the country in 2021. Notifications of the disease rose from 476 in 2019 to 1,471 in 2021. There are cases in approximately half of the 50 US states, with the majority concentrated in California, Nevada, Texas and Florida.
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One of the biggest concerns is the high resistance of some strains of C. auris to the main classes of antifungal drugs. Data from the CDC show that about half of patients die within three months of infection. The main victims are the elderly and people with weakened immune systems.
“Infections are, in general, very difficult to treat because the fungus is resistant to the medications we have”, explains professor of medical immunology André Moraes Nicola, from the University of Brasília (UnB).
O candida auris is an emerging fungal species first identified as causing disease in humans in 2009 in Japan. In the following years, outbreaks were recorded in India, South Africa, Venezuela, Colombia, United States, United Kingdom, Spain and Brazil. Most cases are limited to the hospital environment.
According to Moraes, infected people who develop the disease are generally patients with very fragile health, such as the elderly, people with underlying disease, and hospitalized in intensive care units (ICU). “It is even more difficult to treat because these individuals are already in poor health”, says Moraes.
Alert in USA
In all, US authorities have recorded 3,270 infections from candida auris in the USA between the beginning of 2016 – when the first report was made – and the end of December 2021. About 7,400 screenings were carried out, where the fungus was identified, but there was no contamination. According to the study, there was a faster increase in the number of infections in the years 2020 and 2021 and the trend was repeated in 2022.
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“The rapid increase and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded laboratory capacity, faster diagnostic tests, and adherence to infection prevention and control,” says CDC epidemiologist and lead author of the paper, Meghan Lyman, in a statement.
Authorities attribute the outbreak of recent years to a number of factors, including poor practices in general infection prevention and control and pressure on the health care system during the pandemic, when attention was focused almost exclusively on fighting the coronavirus.
Risk for Brazil
The largest Brazilian outbreak occurred between November 2021 and February 2022 in a hospital in Recife, Pernambuco. The UnB professor believes that the fungus continues to circulate in the country, but limitations in diagnostic tests make it difficult to identify.
“It is a super common fungus, but difficult to identify. We need very specific lab tests because it’s easily confused with other types of the fungus. It is possible that we have cases in various corners of Brazil, but we have not been able to find them”, explains Moraes.
symptoms and prevention
Patients may experience classic symptoms of infections, such as fever and difficulty breathing, as well as a drop in blood pressure, drowsiness and even coma.
The main strategy for preventing outbreaks is to ensure that hospitals have surveillance infrastructure in place to detect the fungus as soon as it appears. “With no structure for detecting the fungus in hospitals and in the Unified Health System (SUS), we ended up letting it escape, increasing the chances of more people dying”, says the UnB professor.
From an individual point of view, the population can protect themselves by washing their hands frequently and making sure that the equipment used in hospitals is sterilized.
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The post Candida auris: fungus that puts USA on alert has already caused an outbreak in Brazil first appeared on Metropolises.
