I’ve written blogs about deadly bacteria and viruses in the past, and those are the organisms most often responsible for deadly outbreaks. BUT, there are equally lethal fungal infections that spread among the North American population.

Such a fungal infection, from the Cryptococcus family, is an example. It usually affects the lungs because the fungal spores are airborne and inhaled. But the infection can spread to other organs of the body if not treated appropriately.

These deadly cryptococcal infections are caused by either of two types of Cryptococcus fungi: Cryptococcus neoformans and Cryptococcus gattii.

In the absence of therapy, the infection quickly spreads to the brain and other organs, often with fatal results. Even with therapy, the infection is sometimes deadly. About a third of those infected die from the disease.

The treatment is antifungal drug therapy, a painful infusion that is given daily over a period of months. At times, the therapy fails and patients may be forced to undergo corrective surgery to rid the body of the infected tissue.

The disease was first detected in 1999 when hospitals in Vancouver Island, Canada saw a sudden spike in cryptococcal cases. By the next year, veterinary hospitals were seeing a similar spike in animal cases.

It was not until 2002 that the increased incidence of the fungal disease was seen in individuals outside of Vancouver Island and in people who had never visited there. By 2007, more than 200 cases were identified across Canada and the infection spread south across the US border.

A 2010 report by the US Centers for Disease Control and Prevention (CDC) reported cases not only in humans, but also in domesticated pets and other animals in the states of Washington, Oregon, California, Idaho and Hawaii. The death rate in the Canadian cases has been reported to be about 10%, but there is a dramatic 33% mortality rate for the cases reported in the US. Researchers are still puzzled by the increased fatality rate of the US cases.

Cryptococcus fungal infections are usually found in warmer climates and C. gattii, the more prevalent of the cryptococcal infections, often exists in tropical and sub-tropical regions of the world.

Researchers are concerned that this fungal infection has been found so far north. The cool, dry weather of North America should not be favorable for such an outbreak, and they wonder if global warming is contributing to the disease migration.

Of particular concern is that, in contrast to bacterial and viral infections, a fungal infection usually develops over an extended period of time and sometimes reappear even after successful treatment is completed, making it a perfect biological agent to transform into epidemic proportions. This fact makes a particularly aggressive fungal organism a prime subject for a potential thriller plot.

Healthcare agencies historically don’t focus on potential epidemics from fungal infections, and that may be the most deadly aspect of this outbreak. Clinicians often look first to bacterial and viral assaults before diagnosing disease as fungal attacks, and that mistake increases the likelihood of a fatal outcome from exposure.

Fortunately, increased awareness at the local and regional levels in the US has produced changes in policies to include the possibility of fungal infections as pandemics, and early diagnostic considerations are being implemented.

Much work, however, still needs to be done to develop better, safer and more effective drug treatments and preventive vaccines for the increased incidence of these fungal infections.

Thoughts? Comments? I’d love to hear them!