According to experts, mortality rates from fungal infections and diseases often exceed those for bacterial infections, which might lead to an epidemic; therefore, we need a preventive public health strategy to deal with them.

This story does not include health advice. It is for information, inspiration, and awareness purposes.

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According to this 2022 paper, “fungal infection is the fifth largest cause of death worldwide, yet fungi attract far less interest from researchers than viruses, bacteria or even parasites. However, the rising concern for resistant fungi is, at last, focusing more on developing innovative antifungal agents.”

A paper published in 2021 informs that:

“Invasive fungal diseases due to resistant yeasts and molds are an important and increasing public health threat, likely due to a growing population of immunosuppressed hosts, increases in antifungal resistance, and improvements in laboratory diagnostics.

Researchers of the paper highlight that the significant morbidity and mortality associated with these pathogens bespeaks the urgent need for novel, safe, and effective therapeutics.

They mentioned that “About 13 million people are at risk of a fatal fungal infection worldwide daily, and more than two million people die from fungal-related causes yearly, which makes fungal infection the fifth largest cause of death.”

A paper published in Science in 2012 also highlighted that although fungal infections contribute substantially to human morbidity and mortality, their impact on human health is not widely appreciated.

“Moreover, despite the urgent need for efficient diagnostic tests and safe and effective new drugs and vaccines, research into the pathophysiology of human fungal infections lags behind diseases caused by other pathogens.”

These researchers collectively highlight that invasive fungal diseases are a growing public health concern in an expanding population of immunocompromised hosts. Indeed, attributable mortality may still approach 90% in the most vulnerable patients infected with highly resistant pathogens.

In October 2022, the World Health Organization released a first-ever list of health-threatening fungi. Dr. Hanan Balkhy, WHO Assistant Director-General, said:

“Emerging from the shadows of the bacterial antimicrobial resistance pandemic, fungal infections are growing and are ever more resistant to treatments, becoming a public health concern worldwide.”

Dr. Haileyesus Getahun, WHO Director, stated, “We need more data and evidence on fungal infections and antifungal resistance to inform and improve response to these priority fungal pathogens.”

In February 2023, the Guardian published an eye-opening story titled A growing threat to human health: we are ill-equipped for the dangers of fungal infections, highlighting the growing threat of fungal infections to human health and the lack of preparedness to deal with them.

Another article titled Fungal Infections are becoming more common. Why isn’t there a vaccine? Highlights the key points. It also includes a video conversation with NBC senior medical correspondent Dr. John Torres, who weighs in on how concerned people should be.

What are fungi, and how do they threaten our lives?

Fungi are a diverse organism group that includes yeasts, molds, and mushrooms. They can be found in various environments, from soil and water to plants and animals.

While many fungi play beneficial roles, such as decomposing organic matter and being used in food production (like yeast in baking and brewing), some can pose threats to human health.

One way fungi can threaten human lives is through infections. Fungal infections (mycoses) can affect the skin, nails, respiratory system, and organs.

Common fungal infections include athlete’s foot, ringworm, and candidiasis (yeast infection). The most frequently encountered pathogens are Candida albicans and Aspergillus spp. However, other fungi, such as non-albicans Candida spp., are increasingly important.

In severe cases, fungal infections can be life-threatening, particularly in individuals with weakened immune systems. Additionally, certain fungi, like Aspergillus, Penicillium, and Fusarium, produce mycotoxins, which can contaminate food and cause illness when ingested.

Mycotoxins are “toxic fungal secondary metabolites formed by a variety of fungi (molds) species. Hundreds of potentially toxic mycotoxins have already been identified and are considered a serious problem in agriculture, animal husbandry, and public health.”

Aflatoxins produced by certain molds can contaminate crops such as peanuts and grains. As documented in this NIH book, “Dietary exposure to aflatoxins may result in severe toxic and carcinogenic outcomes in humans and animals. Aflatoxin toxicity may result in nausea, vomiting, abdominal pain, convulsions, and other signs of acute liver injury.”

A 2015 study in Nature concluded that:

“Sequencing of fungal DNA extracted from frozen CNS samples identifies several fungal species. Collectively, our findings provide compelling evidence for the existence of fungal infection in the CNS from Alzheimer’s disease patients, but not in control individuals.”

The rise of resistant fungi, such as azole-resistant Aspergillus fumigatus, is now drawing increased attention to the urgent need for innovative antifungal treatments. This resistance poses significant challenges, as prolonged treatment can lead to further resistance, and agricultural use of azole antifungals contributes to environmental adaptation and cross-resistance.

As researchers strive to understand and combat antifungal resistance mechanisms, addressing the relative neglect of fungal infections and developing effective treatments are critical priorities for global health.

Apart from health, fungi can also cause damage to crops and food supplies, leading to economic losses and food shortages. Plant diseases caused by fungi can devastate crops, affecting food security and livelihoods.

While fungi play essential roles in nature, some species can pose significant threats to human health, agriculture, and the environment. Understanding their biology and risks is essential for effectively managing and preventing fungal-related threats.

What are solutions to combat risky fungi attacks?

As documented in this paper, clinicians currently rely on a limited selection of antifungals, including azoles, polyenes, and echinocandins, which are often associated with issues such as toxicity, poor tolerability, and drug-drug interactions.

Furthermore, various factors hinder the development of new antifungals, including the difficulty of diagnosing fungal infections, the lack of investment in research and development, and the complex cellular structure shared by humans and fungi.

However, there are promising targets for next-generation antifungals, particularly those that disrupt fungal cell wall processes. Examples include drugs that inhibit glycosylphosphatidylinositol (GPI)-anchored mannoproteins and glucan synthase, showing potential for treating resistant fungal infections.

Despite these advancements, the availability of new antifungals remains uncertain, especially in low- and middle-income countries, highlighting the ongoing need for improved access to effective treatments.

The paper pointed out that while mouse studies have shown promising results in protecting against fungal pathogens like Candida, Cryptococcus, and Aspergillus, translating these findings into clinical applications poses several hurdles.

One major challenge is identifying the specific immune responses that confer protection against fungal infections and determining the optimal targets for vaccination. People with weakened immune systems, who are most susceptible to fungal infections, may require novel approaches to stimulate an effective immune response.

This 2021 paper in Nature, “Vaccines for human fungal diseases: close but still a long way to go,” mentioned that encouraging results have been obtained with vaccines composed of live-attenuated and killed fungi, crude extracts, recombinant subunit formulations, and nucleic acid vaccines.

These researchers state, “Despite the substantial global burden of human fungal infections, there are no approved fungal vaccines to protect at-risk individuals. Novel adjuvants instructing the immune system to mount the protective responses needed to fight mycotic infections are under development.”

They inform that “candidate vaccines target common antigens expressed in multiple genera of fungi, thereby protecting against a broad range of mycoses. Encouragingly, three vaccines have reached human clinical trials. Still, formidable obstacles must be overcome before having fungal vaccines licensed for human use.”

Despite these obstacles, researchers believe that advancements in vaccine technology, particularly those witnessed during the COVID-19 pandemic, offer hope for innovative strategies to combat fungal diseases.

Furthermore, increased attention from international organizations and initiatives reflects a growing awareness of the importance of addressing fungal infections, potentially paving the way for significant improvements in treatment and prevention in the years to come.

How to identify risks of fungal infections and lower them

The CDC asks ten questions to find out if you are at risk of getting fungal infections. I provide the questions here so you can check the details on the CDC website and discuss solutions with your healthcare providers.

1 — Where do you live and travel?

2 — What types of activities are you doing?

3 — Do you have a dog or cat?

4 — Have you recently taken antibiotics?

5 — Are you taking any medicine that affects your immune system?

6 — Are you receiving chemotherapy or radiation treatments?

7 — Are you living with HIV?

8 — Are you going to be hospitalized?

9 — Have you recently had a transplant?

10 — Do you have symptoms of pneumonia, not getting better with antibiotics?

The critical points of these questions are harmful fungi can be found in air, dust, and soil. We can inhale fungi when gardening, cleaning animal shelters, or visiting caves. Some parts of the world might have them more.

People with immunity problems, like those living with HIV or cancer, and transplant patients are more susceptible to fungal infections. Fungal infections can have similar symptoms to bacterial infections, but antibiotics don’t work for fungal infections.

Timely testing for fungal infections reduces unnecessary antibiotic use and allows for proper treatment with antifungal medicine.

Conclusions and Takeaways

Dr. Mark Ramsdal, quoted in this article, states, “Most of those are superficial things like athlete’s foot, that no one’s particularly bothered about, but there is a core group that causes life-threatening infections, and particularly in susceptible populations such as the very old or young, and those with immune systems that don’t work properly.”

My concern is deep fungal infections affecting our brains or nervous systems like Aspergilloma, lungs, bloodstream, and urinary tract. For example, histoplasmosis can cause serious infections in the organs of people with weakened immune systems.

Fungi can produce toxins that damage our cells, tissues, and organs. They can invade the body parts and proliferate, causing tissue damage and inflammation. Fungi can also evade the immune system, making it difficult for the body to fight the infection.

The lack of investment in research and development for new antifungal drugs is a significant concern, leaving the medical community ill-equipped to deal with the growing threat.

One of the main issues is that fungal infections often go undiagnosed or misdiagnosed, leading to delayed treatment and poor outcomes. The global health community needs to increase awareness of the threat of fungal infections and invest in research and development for new treatments and diagnostic tools.

Furthermore, invasive fungal pathogens are opportunistic and infect immunosuppressed people, making them vulnerable to morbidity (illness) and mortality (death). Therefore, there is a need for increased awareness and investment in research to address the growing threat of fungal infections globally.

Prevention strategies, like improved hygiene and antifungal medications, are the primary methods for controlling fungal infections. Vaccination is needed but not available yet.

The development of fungal vaccines is challenging due to the complex nature of fungi and the variety of fungal species that can cause infections. Therefore, further research and development of fungal vaccines are critical to addressing the growing threat of fungal infections.

Here are some practical tips from the Cleveland Clinic to reduce risks with good hygiene. As mold is fungal growth and creates mycotoxins, we must protect our homes and offices from mold, as it can cause serious health issues for people with weak immune systems.

Thank you for reading my perspectives. I wish you a healthy and happy life.

If you found this story helpful, you may also check out my other articles on NewsBreak. As a postdoctoral researcher and executive consultant, I write about important life lessons based on my decades of research and experience in cognitive, metabolic, and mental health.