Deadly Fungi Are Infecting More Americans
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Fungal infections kill more than 1.6 million people yearly, according to Global Action for Fungal Infections, a research and fundraising organization. The toll is climbing. Fungi are adapting to rising temperatures in ways that may make them better suited to thrive in the human body, researchers said. And more people undergoing treatments that weaken their immune systems means a larger population vulnerable to severe fungal infections. At least 7,000 people died in the U.S. from fungal infections in 2021, the Centers for Disease Control and Prevention said. In 1969, the CDC reported 450 such deaths. Current cases are likely undercounted because of misdiagnoses, the agency said.
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More than 75,000 people are hospitalized in the U.S. every year with fungal infections, one-fifth of which are caused by Aspergillus, the CDC said. Fatality rates associated with some fungal infections including severe cases involving Aspergillus can exceed 50%, research shows. Fungi, which were among the first complex life-forms on land, became a global public-health threat about 35 years ago amid the HIV/AIDS epidemic as immunocompromised populations began to increase globally, said Michail Lionakis, head of fungal pathogenesis research at the National Institute of Allergy and Infectious Diseases.
Immunocompromised people, including those taking medications that suppress the immune system, are at particular risk of severe fungal infections, infectious-disease experts said. At least seven million people in the U.S. are immunocompromised, according to the CDC, and Dr. Lionakis said the population is growing as more people receive treatments like chemotherapy and organ transplantation. The CDC last month urged patients and healthcare providers to consider fungi a potential culprit if an infection isn’t responding to treatments. The World Health Organization said it plans this year to release a list of priority fungal diseases that it hopes will spur funding for research and drug development.
The Food and Drug Administration has approved four classes of antifungal medications for invasive infections. A new class to treat severe diseases hasn’t been approved in over two decades. Most antifungals for serious infections are toxic, some even at low doses. There are no approved vaccines targeting fungi. Several antifungal drugs are in development and researchers are probing potential vaccines. In a Phase 2 trial, Amplyx Pharmaceuticals Inc.’s antifungal fosmanogepix was found to be effective against Aspergillus, a yeast known as Candida and other rare molds and was well-tolerated by patients. Pfizer Inc. acquired Amplyx last year.
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Unlike bacteria and viruses, fungi, like humans, have eukaryotic cells with complex structures and a clearly defined nuclei—a biological similarity that makes developing nontoxic antifungals and vaccines challenging, researchers said. “It’s hard to make antifungals that are not anti-human,” said Andrej Spec, an associate professor of medicine at Washington University School of Medicine in St. Louis. Rising temperatures may be propelling the spread of some dangerous fungi by encouraging them to adapt in ways that help them better infect humans, said Dr. Spec, who runs a clinic focused on invasive fungal infections. His research shows that potentially deadly fungi including Blastomyces and Histoplasma have significantly expanded their range in the U.S. since the 1950s to include most U.S. states.
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