Deadly airborne fungus in Oregon set to spread

[Temujin]

Well this fucking sucks!

Deadly airborne fungus in Oregon set to spread
The new, rare strain has killed 1 in 4 infected, researchers say
By Charles Q. Choi
LiveScience
updated 6:12 p.m. ET, Thurs., April 22, 2010

A deadly, airborne new strain of fungus has emerged in Oregon. It has killed nearly one out of four known affected people so far and might also attack animals ranging from dogs to dolphins. And it is likely to spread, researchers now warn.

The new strain known as VGIIc of the fungus Cryptococcus gattii not only targets humans but has also proven capable of infecting dogs, cats, alpacas, sheep and elk. Other strains have even infected porpoises.

Although it can spread to mammals, it does not jump from animal to animal. Instead, people and other animals get it from inhaling spores released by samples of the fungus that infect trees.

"It's in the environment, and we're exposed to the environment," researcher Edmond Byrnes III of Duke University Medical Center told LiveScience. "And the environmental range of this has been expanding."

Potential to spread
While scientists aren't sure how the highly infectious or virulent fungus emerged in Oregon, they caution the new strain now looks set to expand to California and other neighboring areas.

"This novel fungus is worrisome because it appears to be a threat to otherwise healthy people," Byrnes said. "Typically, we more often see this fungal disease associated with transplant recipients and HIV-infected patients, but that is not what we are seeing yet."

Symptoms can appear two or more months after exposure. Most people never develop symptoms, but those infected may have a cough lasting weeks, sharp chest pain, shortness of breath, headache related to meningitis, fever, nighttime sweats and weight loss. In animals the symptoms are a runny nose, breathing problems, nervous system problems and raised bumps under the skin.

Treatment requires months to years of antifungal medications, and even surgery to remove the large masses of the fungus known as cryptococcomas that can develop in the body. So far it cannot be prevented, as there is no vaccine.

Origin unknown
The fungus C. gattii was originally linked with eucalyptus trees in tropical and subtropical climates. It first caused an outbreak in temperate climes on Vancouver Island in 1999 that has now spread into Washington and Oregon, where it infects local trees. This earlier strain, VGIIa/major, has killed nearly 9 percent of 218 patients.

After comparing the genes of the new VGIIc strain from Oregon with others, researchers suggest the new strain most likely arose recently, parallel to the outbreak that began on Vancouver Island. So far it has killed five out of 21 patients analyzed in the United States, a nearly 25 percent mortality rate. Lab studies with immune cells and with live mice revealed it is extremely virulent — that is, it can cause severe disease.

Determining the exact origin of the VGIIc strain has proven difficult. Investigations so far have failed to find it in Oregon soil, water or trees. It may have arrived from abroad or originated locally, researchers said.

Because this fungus had been confined to the tropics until now, researcher Wenjun Li at Duke University speculated that environmental changes might be responsible for the evolution and emergence of these new strains.

"We are trying to put together the evolutionary story of where these types come from by closely studying the genetics of all samples possible," explained researcher Yonathan Lewit at Duke University Medical Center.

It remains uncertain why VGIIc and VGIIa/major are more virulent than other strains. One possibility, given how this fungus can reproduce sexually, new hypervirulent combinations of genes emerged due to sex. The researchers also noted that cell components known as mitochondria in these strains could adopt a distinctive tube shape. Since mitochondria help generate energy in cells, it is possible these strains are more energetic, "but that's just speculation right now," Byrnes said.

When it comes to a public response to outbreaks of these strains, "public health officials in that area have formed a working group with state epidemiologists from all those states in the Pacific Northwest," Byrnes noted. "It's important that public awareness expand on this."

The scientists detailed their findings online April 22 in the journal PLoS Pathogens.

© 2010 LiveScience.com. All rights reserved.

First thing I thought when I saw the title was "I bet this is global warming related", sure enough it looks like it may be. We're probably going to have a lot of these types of surprises popping up over the next few years.

[The Duchess of Zeon]

It's still far less severe than malaria or breakbone fever in the tropics, or Chagas in South America. Really America has just been astonishingly lucky in terms of avoiding diseases. And I suspect the survival rate will go up once they educate medical personnel in the area to screen for it. Also remember that the earlier strain has in 11 years killed all of 22 people in the Pacific Northwest--an area with a population of 13 million. This more virulent form would have killed all of 50 - 55 people in the same period, or about five a year out of a population of 13 million. You're more likely to die of lightning, choking on coffee, or an allergic reaction to anesthetic or the reflective material they use inside your body for MRI/CAT scanning.

[Temujin]

Absolutely, it just sucks that this is probably only the tip of the iceberg regarding what were going to see once the climate really starts going ape shit.

Not to mention the whole killer fungus thing is a bit X-Files style creepy.

[Broomstick]

It's still far less severe than malaria or breakbone fever in the tropics, or Chagas in South America. Really America has just been astonishingly lucky in terms of avoiding diseases.

Not entirely luck - it also has to do with a relatively low population density until recently, lack of domestic herd animals until recently, and such factors.

And I suspect the survival rate will go up once they educate medical personnel in the area to screen for it.

Actually... maybe not. We don't have a lot of good anti-fungal medications, and those we do have take (as noted) months or longer to work, and frequently have toxic side effects because fungus is biochemically more similar to us than bacteria or viruses, so what makes fungus ill or kills them tends to do the same to us.

It's NOT the first "killer fungus" discovered, there are other varieties and they exist in all climates. It's a little unusual for healthy people to come down with such infections but it does happen.

You are correct, it's a rare illness. Rather like hanta virus - it's out there, but even in areas where its most prevalent it's still not a common disease.

[Erik von Nein]

I'm not sure how pointing out that there are other, more dangerous diseases out there is in any way related to the article in the first place. Yeah, it's not HIV, so, uh, no story? Yeah, you probably shouldn't freak out too much, but the point more is that you should be on the look out for it. It's like Valley Fever in California (far too much, as it's another fungus), sure it doesn't infect that many people annually and there are probably other, more dangerous diseases but that doesn't mean the public shouldn't be made aware of its existence, which this article apparently is about.

So far as treatments are concerned they already have treatments for the disease. It was even mentioned in the article. It's years of anti-fungals and possible surgery. Still, I'd be surprised if they are even capable of completely ridding the body of the fungus in the first place. Broomstick is right about anti-fungal effectiveness being poor due to the close relationship with animals. It's unfortunate that they can't identify where exactly the spores are originating from, as that would help public health workers either monitor the spread, monitor spore clouds, or remove the spore-generating fungal masses in the first place. Though, given their usual budgets it'd probably just be the first two.

EDIT: I did find it hilarious that the article pointed out there was no vaccine at the time.

[Alyrium Denryle]

*shrug* As Pianka has been quoted as saying: "If we do not control our population, pathogens will"

[The Duchess of Zeon]

Actually... maybe not. We don't have a lot of good anti-fungal medications, and those we do have take (as noted) months or longer to work, and frequently have toxic side effects because fungus is biochemically more similar to us than bacteria or viruses, so what makes fungus ill or kills them tends to do the same to us.

I wasn't thinking of any major improvement, because antifungal is quite hard. I wonder if treating it like cancer and trying to kill the masses of fungal spores inside of someone with chemotherapy would work, though? Cancer cells are also very similar but not quite like the other cells of the human body. Probably not, but just a thought. I was just thinking that if we could correctly diagnose it within the first month or so that, you know, the survival rate might go from 75 -> 85% or so.

But essentially that was the purpose of my post--that this is nothing to get worried about.

[PainRack]

I wasn't thinking of any major improvement, because antifungal is quite hard. I wonder if treating it like cancer and trying to kill the masses of fungal spores inside of someone with chemotherapy would work, though? Cancer cells are also very similar but not quite like the other cells of the human body. Probably not, but just a thought. I was just thinking that if we could correctly diagnose it within the first month or so that, you know, the survival rate might go from 75 -> 85% or so.

But essentially that was the purpose of my post--that this is nothing to get worried about.

Chemotherapy just means killing something using chemicals, and yes, there is a category of chemo drugs called anti tumour antibiotics. Well, technically, its more of chemo drugs falling into multiple categories based on how you wish to classify them....
http://www.doctorslounge.com/oncology/d ... omycin.htm

As it is, amphotericin B works along the same way. You hang up this foul yellow solution for 4 hours or so and infuse it slowly, praying that the paracetemol and other pre-meds work to suppress your body reaction to it. And the IV infusion lasts for MONTHS. http://en.wikipedia.org/wiki/Amphotericin_B