WHO releases list of threatening fungi. The most dangerous might surprise you

Aspergillus fumigatus can infect the lungs, causing pneumonia-like symptoms that can progress into more severe sickness.

When you think about lethal fungi, you might picture clever false morels that can transform a joyful day of foraging into an evening of stomach pain or poisonous red mushroom caps with unique white dots.
However, the planet’s deadliest fungi are essentially undetectable to the human sight.
The World Health Organization published a list of priority fungal infections on October 25 in response to the growing threat of invasive fungal illness, and you might be surprised by which ones are the most hazardous. All of them are minute fungus, some of which are lethal.
“Fungi are the ‘forgotten’ infectious disease. They cause devastating illnesses but have been neglected so long that we barely understand the size of the problem,” said Dr. Justin Beardsley, of the University of Sydney Infectious Diseases Institute, in a statement. Dr. Beardsley led the WHO Fungal Priority Pathogens List’s study group.
The priority list breaks down 19 of the most common fungal pathogens into three priority tiers based upon surveys and discussions with fungal infectious disease experts. The most dangerous is the “critical group,” which contains just four fungal pathogens: Cryptococcus neoformans, Aspergillus fumigatus, Candida albicans and Candida auris.
Both the invasive fungus Cryptococcus and Aspergillus can cause pneumonia-like symptoms in the lungs, which can develop into a more serious illness. Candida albicans often dwells inside the body and on the skin without posing any health risks. However, if it begins to spread unchecked, it may cause vaginal candidiasis, also known as vaginal yeast infection, or mouth- and throat-thrush. There is currently little information available on the rising fungus danger known as Candida auris. But it frequently evades treatment and has led to major outbreaks in hospitals.
Experts who considered the impact of the fungus’s disease on public health and the amount of research and development it has received to date determined the ranking of fungal infections.
The 2017 Bacterial Priority Pathogens List, which the WHO utilized to help focus resources on bacterial infections that were the most under-researched and posed the biggest hazards to global health, served as both an inspiration for the list and a model for it. With the publishing of the Fungal Priority Pathogen List, it is hoped that policymakers will have rules in place to help them focus resources on the most urgent invasive fungal infections.

Infectious fungi are opportunists

Contrary to popular belief, the majority of fungus don’t have any negative effects on people. Only a small proportion of mushrooms are edible. Only 200 of the 150,000 fungal species described, according to a new study, are infectious to humans.
Infectious fungi are frequently opportunistic pathogens, which means we are constantly exposed to them even though they only infect persons with compromised immune systems.
Consider the fungus Aspergillus fumigatus. It is a relatively common fungus that is almost always found in decomposing leaf litter. According to Michelle Momany, a University of Georgia professor who researches Aspergillus, “everyone of us inhales between 10 and 100 Aspergillus spores a day,” according to current study.
Compared to other infectious diseases, invasive fungal infections spread extremely differently. According to Momany, who was not involved in the drafting of the priority list, “These fungal illnesses, when you get them, it’s not from another person, you get them from the environment.”
This isn’t a major concern for most individuals, but it could be fatal for others. Those with weakened immune systems are unable to fight off these fungal pathogens, which could result in a clinical illness, according to Momany.
The burden of infections
Despite the fact that many of these fungal infections are relatively common, the WHO report says a lack of data means it’s impossible to estimate the exact burden these diseases have on the global population.

The World Health Organization’s first-ever Fungal Priority Pathogens List breaks down 19 of the most common fungal pathogens into three priority tiers.

“Some of the best estimates out there say at least 1.5 million deaths a year are caused by invasive fungal infections. That’s on the same order as malaria. But people don’t think about fungal diseases in the same way,” says Momany.
Momany contends that part of the problem is clinicians’ lack of understanding, and that a lack of appropriate diagnostic equipment may prevent fungal infections from being identified when a patient presents with an infection. According to her, “fungal illnesses are frequently identified through autopsy, which causes a problem with underreporting.”
However, the publication of this priority list may help focus more attention and resources on developing new diagnostic instruments, novel therapies, and improved clinical training. This project has, according to Dr. Orla Morrisey, co-chair of the Australia and New Zealand Mycoses Interest Group, “truly focused the global mycology community on the challenge ahead.”

Antimicrobial resistance

The publication of the list coincides with an increase in the prevalence of invasive fungal diseases and antibiotic resistance in invasive fungi.
According to Dr. Hanan Balkhy, WHO Assistant Director General for Antimicrobial Resistance, fungal diseases are on the rise and becoming a global public health problem as they emerge from the shadows of the bacterial antimicrobial resistance pandemic.
A class of antifungal medications known as azoles is one of the primary instruments that clinicians use to treat a fungal infection. However, invasive fungal pathogens have adapted and developed resistance as usage has grown, much to how many bacterial illnesses have done with antibiotic resistance.
However, unlike bacterial resistance to antibiotics, ambient antifungal usage can help to explain the origin of this resistance to fungi. It is now quite obvious that agricultural use is what is causing part of the clinical resistance to an azole, one of the main fungicides used to protect crops from fungus, adds Momany.
Morrisey urges increased spending on fundamental research, claiming that “this is the key to generating novel treatments and diagnostic tests” that could be used to identify and treat infections that are resistant to antifungal medications.
The publication of the priority list should increase interest in and funding for combating these invasive fungal infections. The World Health Organization tracking it now and drawing attention to it is really tremendous, according to Momany. “What’s nice about [the publishing of the priority list] is that it all pulled together now in a way that can guide policy.”



by: Miss Cherry May Timbol – Independent Reporter
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