THURSDAY, July 22 (HealthDay News) --
Cryptococcus gattii -- an airborne fungus that can cause
life-threatening illness -- is an emerging infection in the Pacific
Northwest, U.S. health officials said Thursday.
While
C. gattii infections are rare -- only 60 cases have been
reported since 2004 -- they can be severe and even fatal,
researchers at the U.S. Centers for Disease Control and Prevention
report in the July 23 issue of the
Morbidity and Mortality Weekly Report.
"
C. gattii is still rare so we don't want people to panic or
to misunderstand the risk of infection, but it is serious," said
co-author Julie Harris, of CDC's National Center for Zoonotic,
Vector-Borne, and Enteric Diseases.
Harris explained that people get the infection by breathing in
the spores of the fungus, which live in the environment and are
usually found in the bark of certain trees and the surrounding
ground.
C. gattii infection causes a prolonged cough, shortness of
breath, headache, fever, weight loss, and, in some patients, a
stiff neck, according to Harris. The fungal infection is not
contagious among people, she added.
Symptoms can take months to develop after exposure, with the
median time being six to seven months, and incubation periods as
short as eight weeks and as long as 13 months.
Of the 60 reported U.S. cases of
C. gattii since 2004, 43 were in Oregon, 15 in Washington and
one each in California and Idaho, the report noted.
Among the 47 patients whose medical information was known, 81
percent had another underlying disease -- including three patients
with HIV -- that could have made them susceptible to
C. gattii infection, the report indicated.
Nine of the patients who were tracked after becoming infected
(20 percent) died due to their infection, and six others died with
the infection. But only two of the nine who died due to
C. gattii had no predisposing condition, the findings
showed.
Harris noted that the total number of cases of
C. gattii infection is unknown, because only the more severe
cases tend to be reported. But she expects to see more mild cases
as people become aware of the infection.
"We don't know at this point what the true case fatality rate is," Harris said. "As with any new disease, what you usually see is that mild cases go undetected, so probably the case fatality rate is going to be lower than what we are seeing right now."
Treatment for
C. gattii consists of six to eight weeks of intravenous
anti-fungal medications, followed by six months or more of oral
fluconazole and it "is not always a pleasant treatment," Harris
added.
At the moment,
C. gattii appears to be confined to the Pacific Northwest. It
could spread, but Harris said that might not happen because "fungi
need very special environmental conditions to survive and to
propagate."
Why this infection -- typically a tropical disease -- is now
cropping up in the United States is not known, Harris stated. It is
endemic to Australia and Papua New Guinea and has been seen in
northern Africa, Asia, Brazil, Columbia and parts of the
Mediterranean, she said.
However, the type of
C. gattii seen in the United States is uncommon in other
parts of the globe, according to the report, which noted that one
Pacific Northwest subtype has never been seen before.
The CDC is also aware of 52 cases of infection among
animals.
"It can be fatal to animals. Animals are closer to the ground, they're sniffing around, so we think they are probably more susceptible to infection than humans," Harris said.
Infectious disease expert Dr. Marc Siegel, an associate
professor of medicine at New York University, said while the number
of infections is small,
C. gattii is an emerging infection that needs to be taken
seriously.
"We never know which emerging strain of a bacteria or fungus is going to be the one we have to worry about," Siegel said. "This one, which is becoming hardier and more drug-resistant, is one that needs to be on our radar screen," he said.
More information
For more information on
C. gattii, visit the
Oregon Department of Human Services.