Global deaths from fungal infections have doubled in a decade

Scientists have estimated that, in a decade, fungal infections have doubled globally. According to a recent study published by David W. Denning, Principal Investigator of Manchester Fungal Infection Group at the University of Manchester, indicates a significant rise from 2 million to approximately 3.8 million deaths annually due to fungal infections.

This alarming figure constitutes around 6.8% of total global deaths. While coronary heart disease accounts for 16% of the world's total deaths, it is followed by stroke at 11%, smoke-related lung disease (COPD) at 6% and fungal infections responsible for about one-third of these 3,228,000 deaths.

The study, published in Lancet Infectious Diseases, highlighted the proportion of fungal cases actually diagnosed and treated and those that were missed.

The researcher revealed that although fungal disease diagnostics have improved in the last ten to 15 years, both access to and actual usage of these tests is limited, and not just in low-income countries.

He wrote that in many places different kinds of fungal infections are diagnosed even though some of the most common types of fungus remain unnoticed, leading to increased global deaths.

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Many of these people die because their doctor does not recognise that they have fungal disease or they recognise it too late, wrote the scientist.

But also, many of the deaths are down to slow or absent diagnostic testing and a lack of effective antifungal drugs.

Tests based on fungal cultures only identify about a third of people who actually have a fungal infection. He revealed that just like antibiotic resistance, antifungal resistance is a growing problem too.

Spraying crops with certain types of fungicides is greatly increasing resistance rates to a group of antifungal drugs, known as azoles.

Candida infections can lead to sepsis and are present in the blood. They are associated with diabetes, renal failure, or both, and can occur after significant surgery or trauma. Although this fungus is normally in our gut, when we are very sick, it can move from the gut into the bloodstream.

More than 1.5 million people worldwide are affected by serious Candida infections, causing nearly 1 million deaths each year. Improved diagnostic tests are needed because the current blood culture tests can only detect 40% of these life-threatening Candida infections.

About 50% of the approximately 6,00,000 deaths from Aids are attributable to fungal infections.

Covid-19 and Black fungus

India saw the first major outbreak of mucormycosis, or black fungus, after Covid-19. This fungus, causing tissue death, led to over 51,000 reported cases during the pandemic, a drastic increase from the estimated 10,000 global cases in 2012.

Factors like excessive steroid use and uncontrolled diabetes contributed to this trend.

Notably, the spike in fungal diseases among Covid-19 patients, like Aspergillus and Candida infections, globally wasn't considered in recent figures, suggesting the actual numbers could be higher.

Double whammy

Individuals in intensive care with influenza face an elevated risk of life-threatening Aspergillus infection, which doubles the risk of death even when Aspergillus is identified. Concerns among doctors and scientists revolve around the potential for a simultaneous outbreak of fungal infections and influenza or another respiratory virus, creating a dual-threat scenario.

There is also a strong association between fungal allergies and severe, or poorly controlled, asthma.

"Fungal diseases are here to stay. We are surrounded by them, and they live in our guts and on our skin," wrote Prof David W Denning.

He added, "There are no vaccines for fungi. Severe fungal disease strikes when people are already ill, with only a few exceptions in healthy people and in those living or working in mouldy homes or work environments. That is why accurate and timely diagnosis is desperately needed, and why we need to take fungi very seriously."