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If you had to name some of the planet’s most
life-threatening fungal diseases, would you know where to
begin?
If not, then look no further than the
UN World Health Organization (WHO), which has just catalogued
the 19 fungi that represent the greatest public health risk
today.
The aim of listing these fungal “priority
pathogens” is to promote research and
strengthen our response to fungal infections and
antifungal resistance.
People most at risk
are those with underlying health problems or a weakened
immune system, WHO said.
And
just how important the issue is, was demonstrated during the
COVID-19 pandemic,
when invasive fungal infections increased
significantly among hospitalized patients, “often
with devastating consequences”.
“New groups at
risk of invasive fungal disease are constantly being
identified,” WHO warned on Tuesday. “As the fungi that
cause common infections – such as candida oral and vaginal
thrush – become increasingly resistant to
treatment, risks for the development of more
invasive forms of infections in the general population are
also growing.”
Growing public health
concern
There are only four types of antifungal
medicine available today, which is a problem, as fungal
infections are becoming more common and resistant to
treatment.
Even more worrying is the fact that “most
fungal pathogens lack rapid and sensitive diagnostics, and
those (medicines) that exist are not widely
available or affordable globally”, WHO
said.
People at greatest risk from invasive fungal
infections include those with cancer, HIV or AIDS, organ
transplants, chronic respiratory disease and
tuberculosis.
Latest data shared by WHO indicates that
fungal diseases are expanding in number and
reach worldwide. Global warming
and the increase of international travel and trade are
believed to be responsible, the UN health agency
said.
To give an idea of the scale of the potential
threat posed by fungal infections, WHO noted that
drug-resistant bacterial infections already “directly
cause 1.27 million deaths and…contribute
to approximately 4.95 million deaths every
year”.
Step up surveillance
Among its top
recommendations to countries seeking to tackle fungal
disease, WHO urged the strengthening of laboratory
and surveillance capacities, to better understand
the burden of infection and antifungal
resistance.
“Resistance to antifungal medicines is
partly driven by inappropriate antifungal use,” WHO said,
noting that the ill-judged use of antifungals in agriculture
had been linked to rising infections of a common mould that
has the capacity to spread, Aspergillus
fumigatus.
The UN health agency’s catalogue
focuses on fungal pathogens that can cause “invasive acute
and subacute systemic fungal infections” which have proved
resistant to medication.
The pathogens are ranked and
listed in three priority groups: critical, high and medium.
The critical group includes Cryptococcus neoformans,
Candida auris, Aspergillus fumigatus and Candida
albicans.
The high group includes Nakaseomyces
glabrata (Candida glabrata), Histoplasma spp., eumycetoma
causative agents, Mucorales, Fusarium spp., Candida
tropicalis and Candida
parapsilosis.
Pathogens in the medium group are
Scedosporium spp., Lomentospora prolificans, Coccidioides
spp., Pichia kudriavzeveii (Candida krusei), Cryptococcus
gattii, Talaromyces marneffei, Pneumocystis jirovecii
and Paracoccidioides
spp.
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