Saturday, December 15, 2007

The Forgotten Fungus

When reports first came out about the “deadly fungus” the newspapers were flooded with articles pertaining to Cryptococcus gatti. Nowadays, the newspapers only occasionally report on the “forgotten fungus”.

On June 6, 2002 the B.C. Centre for Disease Control issued a health advisory, including possible symptoms of the disease, as to the emergence of Cryptococcus on Vancouver Island. Cryptococcus is a microscopic yeast that is found in the air, trees and soil of Vancouver Island and is responsible for disease in humans and animals in British Columbia since 1999. Cryptococcus is found throughout the world, in Southern California, Australia, Central and South America, Africa, India, South-east Asia and Spain, but is new to Canada. It is not known exactly how the Cryptococcus fungus came to be in British Columbia but it is suggested that imported tropical plants are to blame or that it may have always existed here and is now prevailing due to climate or environmental changes (ie increased air borne concentrations due to drier than normal summers). Either way, it has been considered the world’s largest outbreak of Cryptococcal disease ever identified.

Cryptococcal disease is caused by the inhalation of the air borne fungal spores that can be carried via wind many kilometers from the source. The disease cannot be transferred human to human or from animal to human and vice versa, it is not contagious. Once in the lungs, Cryptococcus gatti can cause pneumonia, meningitis, lung nodules, and can affect the central nervous system. The incubation period is anywhere from 2 to 9 months and initial symptoms can include headaches, night sweats, fever, prolonged cough, and weight loss in humans and runny noses, coughs, lumps under the skin, changes in personality, blindness, and seizures in animals. Cryptococcal disease can be diagnosed in humans and animals by using an antigen test and if detected early enough, can be treated with antifungal medication.

There is no vaccine for Cryptococcus and no recommended precautionary measures to avoid the disease. Nor are there any fungicides or chemicals to apply to the trees for protection. However, knowing the symptoms and alerting your doctor or veterinarian is helpful in early diagnosis and treatment. It is reported that even in central Vancouver Island areas, doctors and veterinarians are not very familiar with the disease and outside of B.C. most physicians are not aware that Cryptococcus gatti may be responsible for infection. On a more positive note, not everyone who breathes in the airborne spores becomes sick. Areas of Vancouver Island where the fungus was first located remain open to the public and none of the people who regularly work there have ever reported serious illness. The risk of contracting the disease is very low considering the amount of exposure and confirmed cases in the past. Thus, the benefits of getting outside and remaining active should strongly out way the risk of infection.

Although Cryptococcus gatti is responsible for what has been considered the world’s largest outbreak of Cryptococcal disease ever identified, it has failed to capture the attention of the media. Even in central Vancouver Island where the fungus is most prevalent, there is very low coverage. It is estimated that Cryptococcus gatti has had less than one fifth the coverage West Nile has received, and West Nile has yet to even spread into British Columbia. The majority of the 176 confirmed cases from 1999-2006 are linked to Vancouver Island, however, by the end of last year 6 cases where confirmed on the lower mainland with absolutely no link to the island. Though it has not had the media coverage it perhaps should have, the expansion of Cryptococcus gatti shows it is a fungus to be reckoned with.



Dominic B. said...

Like any fungal infection, people who are the most affected are the ones with a weaker immune system, the elderly and young children. An obvious reason for this lies in the fact that cellular immunity is quite effective against fungi

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