Tropical fungus spreads illness in Northwest


July 23--Health officials are on the lookout for a new fungus taking root in the Northwest that in the past several years has sickened five dozen people, some fatally.

The federal Centers for Disease Control and Prevention on Thursday published in a weekly report with public health information about Cryptococcus gattii, a fungus with tropical origins that can cause respiratory illnesses if its spores are breathed in by people or animals.

The fungus lives on and around trees, and there are no particular precautions people can use to avoid exposure.

But health officials were quick to caution against public panic over C. gattii, as illnesses caused by the fungus are not contagious and infections in the Northwest to date have been sparse and isolated.

"The benefits of outdoor activity outweigh the very small risk of C. gattii infection," said Nicola Marsden-Haug, an epidemiologist for the state Department of Health. "This is really a very rare disease."

Fungal infections from C. gattii first were seen on Vancouver Island in 1999. By 2004, infections were being seen in residents of mainland British Columbia, where the number of reported infections totaled 218 by the end of 2007, according to the CDC report.

The first human infection in the United States was reported in Oregon in December 2004. By this month, the CDC had reports of 60 people becoming ill after exposure to the fungus -- 43 in Oregon, 15 in Washington, one in California and one in Idaho.

Of those 60, nine died because of the fungal infection and another six died of other reasons while infected with the fungus, according to the CDC.

Dr. Larry Jecha, health officer for the Benton-Franklin Health District, said no C. gattii infections have been reported in the two counties.

Marsden-Haug said of the 15 cases reported in Washington, one was a person who lives in Eastern Washington but who could have been exposed anywhere.

There are a few things that have public health officials' interest about the fungus piqued. It's similar to other more common Cryptococcus species, but is slower to respond to medical treatment and has sickened people who otherwise were healthy.

The more commonly seen Cryptococcus neoformans typically only sickens people with severe immunodeficiencies, such as those infected with HIV, according to the CDC.

Another concern is that people exposed to the spores may not become sick for months, or more than a year, after breathing them in.

Epidemiologists are trying to make doctors, nurses and other health care providers aware of the fungus so they can report it if they see it and make sure they're giving patients the right treatment.

Fungal infections require very different treatments than bacterial infections, which are treated with antibiotics, or viral infections, which can be treated with antivirals, although treatment often amounts to plenty of rest and fluids.

Antibiotics won't work on C. gattii, which instead can require intravenous anti-fungal medications and can take weeks to treat.

When breathed in, the fungus colonizes the nasal cavity and sinuses, and can cause pneumonia or meningitis as well as lesions called cryptococcomas on the eyes, skin, lungs and brain.

Symptoms of a C. gattii infection include a prolonged cough lasting weeks or months, chest pain, shortness of breath, severe headache, fever, night sweats and weight loss.

Marsden-Haug said people with those symptoms should talk to a doctor. Doctors who identify a C. gattii infection are required to report it to the local health department.

The other thing catching scientists' attention about the fungus is its sudden spread in the Northwest. The fungus typically has lived in tropical and subtropical climates in places such as South America, Australia or Asia.

Its appearance in a temperate northern climate could indicate the fungus is adapting or has a wider climate tolerance than previously thought, or climate change might be creating conditions where the spores can survive, according to the CDC report.

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