In the last ten years, deaths from fungal infections have doubled worldwide
11 years ago, a study conducted by scientists at the University of Manchester showed that two million people worldwide died from fungal infections every year. A new estimate by David Denning, a researcher at the same university, nearly doubles that number to about 3.8 million a year.
For comparison, this is about 6.8 percent of the total global death rate. Coronary heart disease accounts for about 16 percent of the world's total death rate, stroke for 11 percent, smoking-related pulmonary disease (COPD) for 6 percent, and fungal infections for about one-third, or 3,228,000 deaths.
According to other comparative global death statistics, pneumonia (sometimes fungal) kills about 2,600,000 people a year, tuberculosis 1,208,000 (of which the fungal disease is mostly unconfirmed and probably 340,000).
David Denning estimated in a study the approximate proportion of fungal diseases diagnosed, treated and survived. Although the diagnosis of fungal diseases has improved greatly in the last 10-15 years, access and use of tests is limited, and not only in low-income countries.
For example, South Africa has an enviable diagnostic service for fungal (cryptococcal) meningitis and fungal bloodstream infections (Candida), but no diagnostic services for infections caused by another highly prevalent fungus, Aspergillus. This deficiency contributes significantly to mortality. In particular, timely diagnosis of Aspergillus infections, ideally within 48 hours, would save millions of lives every year.
The most deadly fungi are Aspergillus fumigatus and Aspergillus flavus, which cause fungal infections. Among the victims are people with lung diseases, such as asthma, tuberculosis and lung cancer; Also those who have leukemia or who have had an organ transplant or are in intensive care.
Many of these people die because their doctors don't know they have a fungal infection—or they find out too late. At the same time, one of the causes of death is the scarcity or absence of diagnostic tests and the absence of effective antifungal drugs. Tests based on fungal cultures actually only detect about a third of cases in people who actually have a fungal infection.
Unfortunately, resistance to antibiotics and fungicides is also becoming a growing problem. The use of certain types of fungicides in agricultural crops greatly increases the rate of resistance to a group of antifungal drugs called azoles.
Candida infections occur in the bloodstream and are one of the causes of sepsis. It is also associated with diabetes and kidney failure—or both—and can worsen after major surgery or trauma. This fungus is a normal part of the gut microbiome, but when we are very sick, it migrates from the gut wall into the bloodstream.
Globally, about 1.5 million people are infected with life-threatening Candida infections each year, and nearly a million of them die; Therefore, diagnostic tests are urgently needed. Current blood culture tests detect only 40 percent of life-threatening Candida infections.
50 percent of the 600,000 people who die of AIDS each year are related to fungal infections . Globally, there is a major effort to eradicate cryptococcal meningitis as a cause of death, led by the US Centers for Disease Control and Prevention and the World Health Organization.
black mushroom
The world's first large-scale outbreak of mucormycosis, a.k.a. black fungus , in India was attributed to COVID-19. This fungus blocks the blood supply to the tissue and causes its death. Hence it was called "black mushroom".
In 2012, David Denning and his colleagues estimated approximately 10,000 cases of mucormycosis worldwide . In India, the Covid pandemic has resulted in at least 51,000 confirmed cases of this fungal infection; Such a massive increase is linked to factors such as overuse of steroids to treat covid (too much and for too long) and poor diabetes control.
Worldwide, Aspergillus and Candida infections were also significantly more common in intensive care covid patients.
double blow
Life-threatening Aspergillus infections are also high in people admitted to intensive care units with the flu, doubling the risk of death even if Aspergillus is diagnosed. Indeed, doctors and scientists fear a double whammy epidemic caused by fungal infections and influenza or another respiratory virus .
There is also a strong association between fungal allergy and severe, poorly controlled asthma.
Asthma is a common and growing problem in the elderly. People with fungal asthma generally need several medications.
Despite efforts to control asthma, approximately 461,000 people worldwide die each year from this disease alone or from another disease.
Fungal diseases are not necessarily going to disappear. They are all around us and nest in our guts, skin.
There is currently no vaccine against the fungus. Acute fungal diseases attack people when they are already sick. It is rare for it to happen to a healthy person.
The study was published in Lancet Infectious Diseases .
Adapted from The Conversation.