We know that
bacteria
are fought with antibiotics and, due to Covid 19, we have become a bit of an expert on
viruses
, their forms of transmission, risk groups and the importance of vaccines.
What would be falling
off the radar
is what happens with
fungi
.
Last week
The Last of Us
premiered , a series that poses a dystopian scenario in which humanity is affected by this pathogen.
It is science fiction (fortunately) but it serves to put this issue on the agenda, which the World Health Organization (WHO) also referred to a few months ago, which released a list of
19 fungi considered "of concern".
Two mycology specialists respond to
Clarín
in this regard: how many are there, where are they, how are they spread, what treatments exist and if they may be associated with a threat to health in the future.
Roxana Vitale, a CONICET researcher, specialist in medical mycology and head of the Mycology service at the Ramos Mejía Hospital, says that there are
more than a million fungi
distributed among humans, animals and plants and that there are
700 that have been described as agents of infection of people.
According to specialists, fungal infections have different origins.
The
severity of these infections will depend on many factors: the type of fungus, the way the infection develops and, to a large extent, the
host
.
How do they spread?
"Infections can be given by
contact, inhalation
or as a consequence of
trauma
," Vitale details.
With contact it refers to petting an infected animal or touching surfaces such as the floor of a shower in which certain humidity conditions exist that make it possible to spread what is known, for example, as
athlete's foot
.
Contagion by trauma occurs when the person is pricked by
thorns from trees, plants or wood splinters
.
"In some cases, the disease associated with the fungus develops quickly and in others, late," says the specialist.
Fungi
do not only affect the skin or nails
, nor are they always superficial.
“There are also deep infections that usually occur by
inhalation
and generally affect immunosuppressed people.
These are
opportunistic fungi
, which precisely take advantage of the lack of defenses ”, he maintains.
deep infections
It refers to
infections that can damage the central nervous system, the lungs or other organs
and highlights that the vast majority of those affected are immunosuppressed patients.
"The conditions among immunosuppressed patients tend to worsen in up to 7% of cases," he says, explaining that contaminated environments are not necessarily closed or dirty.
The environment may appear clean.
"You don't have to have a damp patch on the wall to have fungus. Even outdoors, mold can be found in pigeon or bat feces. Breathing in that space can lead to contagion," she warns.
Infections of this style
are treatable
.
"There are
antifungals
that can be topical, administered orally and intravenously," he says.
However, recently the WHO presented a report on
19 types of fungi "of concern"
for being resistant to drugs.
Among them, the candida auris stood out, which had two affected in Argentina in November last year.
“This is an infection that usually occurs in
hospitals
and generates severe damage among patients with
low defenses,”
Vitale points out.
He says that drug resistance is a problem, but that "there are different drugs to try to
counteract the adaptation mechanisms of some fungi
to be eliminated."
“The most important thing is
suspicion, to reach a diagnosis quickly.
This is not so easy, because you can't suspect something you don't know about.
For this reason, it is essential to deal with these issues, to understand that
the infection is not always due to a virus or a bacterium
, that sometimes there are also fungi or there may be a
coinfection of different pathogens
”, he adds.
The detection occurs from the
taking of samples
, of blood, tissues, respiratory material or urine, as the case may be.
On the possibility that fungi could pose a massive threat, as happened with the coronavirus pandemic, Vitale says he
"doesn't think it will happen."
“There may be small outbreaks, but most likely they will not spread.
In principle, because they
almost always affect immunosuppressed people and not the general population
.
In addition, they require
very specific conditions of temperature and humidity
”, he comments.
Guillermo García Effron, main researcher at Conicet and professor of Mycology at the Universidad Nacional del Litoral, agrees with Vitale about the risks of infections by some fungi and their scope.
“The key to pandemics is that
the pathogen affects immunocompetent patients and with fungi that is the exception and not the rule
.
In the vast majority of cases, it causes damage in the immunosuppressed and the contagion is not registered directly from person to person, ”he highlights.
And he explains that "there are endemic areas in which, due to climatic conditions, certain fungi develop that can affect immunocompetent patients, although they
are limited to specific places
and, therefore, they are usually controlled"
the local situation
"Argentina is one of the only countries in which there are
three fungi that affect patients who are not immunosuppressed,"
says García Effron
.
One
is
histoplasma
, which has its endemic zone in part of the Litoral, Buenos Aires and Chaco.
It is spread by inhalation and is associated with the feces of some animals, ”he says.
And he says that a while ago there was an outbreak among the military who cleaned a warehouse with bat feces.
Another of the fungi is the
paracoccidiodes
, endemic to the area of Entre Ríos, Santa Fe and Chaco that is present, in general, in the
land of the armadillo caves
.
The third is the
coccidiodes
, which is found in arid areas of the provinces of Catamarca and Santiago del Estero.
“When soil is blown up by the wind, people residing in those areas can get infected,” he shares.
"In our laboratory in Santa Fe we are working to improve the possibilities of diagnosis," says the specialist.
And he assures that much remains to be done on this issue.
"We observe that, for example, histoplasma infection
manifests itself in a similar way to tuberculosis
and even on an x-ray it looks similar. Doctors tend to give antibiotics against the bacteria without thinking that it may actually be this fungus" , he explains, and emphasizes that fungi should be considered as agents of infection.
The Last Of Us series can be seen on HBO.
What is
The Last of Us about?
The series begins with a doctor warning that the next threat to humanity might not be caused by a virus or bacteria, but by a fungus.
In addition, he warns about
the existence of a type of fungus that affects the nerve channels of ants
and that, if the temperature of the planet increases, it could adapt to the point of affecting humans.
The plot describes the experiences of Joel and Ellie, who survived a pandemic caused by a fungus, which, when infecting humans, turns them into
cannibalistic creatures
, and which is transmitted through a simple bite.
The Last of Us
, which premiered on HBO Max, is based on a video game that was released in 2013.
SC
look too
"The Last of Us": Is there the Cordyceps fungus that could end humanity according to the HBO series?
Why The Last of Us managed to break "the curse of video games" brought to the screen