A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.

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Since 2016, the number of cases of Candida auris has risen annually. It’s only a matter of time, according to experts, until they are reported in every state. This month, four individuals in the state of Washington tested positive for a rare and potentially fatal fungal infection. According to health officials in Seattle and King County, this is the first known epidemic of the fungus known as Candida auris in the state, despite the discovery of a single locally acquired case in July.

A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.
A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.

There have been no recorded fatalities. The cluster coincides with the ongoing spread of Candida auris in the United States, where case counts have increased year over year since 2016. The pathogen typically infects individuals with compromised immune systems and is resistant to several popular antifungal drugs. Patients in hospitals who utilize feeding tubes, breathing tubes, or catheters are frequently found to have it. Kindred Hospital Seattle First Hill is a long-term acute care hospital where three of the individuals who tested positive in Washington were patients. Their instances were found by means of a regular screening procedure designed to find infections before symptoms appear.

Kindred had previously treated a fourth patient, but the public health authorities for Seattle and King County informed NBC News that the patient’s test results were positive at a Snohomish County hospital. On Tuesday, the agency declared that it received notification of the first occurrence on January 10 and the subsequent two cases on January 22 and January 26. When the patients were admitted to Kindred, all but one of them tested negative for Candida auris, indicating that they acquired the fungus at a later date. According to the health department, one patient experienced an infection, meaning the fungus got into a body organ (the bloodstream, the ears, or an open wound) where it would probably create symptoms. The term “candida auris colonization” refers to the state in which individuals harbor the fungus on their bodies and may potentially transmit it to others without necessarily becoming ill. Individuals who have been colonized by Candida auris remain susceptible to infection.

In a statement, Kindred Hospital Seattle First Hill stated that all three of the impacted patients “were appropriately isolated from the rest of the patient population with extra clinical and cleaning precautions to prevent spread.” As of right now, none of the three patients have symptoms. The first case of Candida auris was discovered in Japan in 2009. In 2016, the Centers for Disease Control and Prevention asked that laboratories in the United States report cases of it. A subsequent check of records revealed cases that date back to 2013.

A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.
A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.

The largest increase since reporting started occurred between 2020 and 2021, when there was a 94% increase in cases of Candida auris. 36 states had reported cases of the fungus as of December 2022. Between 2013 and 2022, the CDC documented over 5,600 cases of Candida auris infections; over 13,000 cases that were found during screenings showed no symptoms of infection. The CDC blames the surge of Candida auris on increased screening as well as inadequate infection control and prevention procedures in healthcare settings. The COVID pandemic’s prolonged patient stays and staffing shortages most likely made this problem worse. “It will undoubtedly affect every region of the nation,” stated Dr. Peter Pappas, an attending physician at the University of Alabama in Birmingham.

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“The question is going to be, How well can we control it?” Approximately 90% of strains of Candida auris in the United States are resistant to the drug that is most frequently used to treat other fungal infections. While medications from one of the three primary classes of antifungal medications can be used to treat most strains of Candida auris, some strains are resistant to all three. The first incidence in Washington, according to the health departments of Seattle and King County, was a resident of Pierce County who was admitted to a hospital there before being sent to Kindred Hospital Seattle First Hill. As part of a state-led initiative that was started in 2022, Kindred is the only hospital in Washington that screens all newly admitted patients for Candida auris. Swabbing the crotch and armpits—two greasy areas of skin where the fungus prefers to settle—is part of the testing procedure. ” The screening program has allowed us to identify many patients in one environment for the first time.

However, it’s challenging to determine the exact amount of C. auris that is in circulation, according to Sharon Bogan, a public health department spokesperson for Seattle and King County. According to Pappas, the four occurrences might indicate that C. auris is becoming more common in the Seattle region. “By the time it shows up in a hospital, you know it’s been in the community for quite some time,” he explained. “It’s just unclear how long that would be.” In most cases, Pappas continued, it is simple to differentiate between an infection and colonization; nonetheless, “there are gray areas.” “Infections in those who have invasive infections simply need to be treated. In the absence of that, the repercussions can be extremely dramatic, “added the speaker. Although healthy individuals seldom contract the infection, severe Candida auris infections in the United States have a 30% to 60% fatality rate.

The chair of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, Dr. Arturo Casadevall, stated that individuals should be comforted when they learn of new cases that have been identified through active surveillance in their states. It is depressing to realize that it exists in certain ways. But what would happen if there was no surveillance? He stated. He stated that “most people shouldn’t have to worry about getting it just because it’s in the community.”

A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.
A dangerous fungal illness that is spreading across the U.S. has found its way to Washington state for the first time.

Individuals can contract Candida auris by coming into close contact with a carrier of the fungus or by coming into contact with infected surfaces or things. The fungus can survive on surfaces for at least two weeks, according to studies. “Once this stuff gets into a hospital, it’s kind of hard to get it out,” Casadevall stated. ANNOUNCEMENT (February 2, 2024, 2:35 p.m. ET): The original version of this story stated that one of the patients left Kindred Hospital prior to receiving a positive test result for Candida auris. Additionally, a statement from the hospital has been included.

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