Recent appearances of a “superbug” strain of fungus have appeared in hospitals worldwide, keeping researchers and epidemiologists on their toes. The fungus, *candida auris*, was first reported only in 2009 in the ear of an elderly woman in Japan. Similar strains appeared in India and Pakistan around the same time. Three years later, the fungus appeared again during testing of infections of eighteen people in India. It shortly appeared in South Africa, Venezuela, Europe, and the United States. It has continued to spread with new cases in new areas reported every month. The US Center for Disease Control calls the fungus a “serious global health threat.”
Hospitals and researchers are finding the fungus extremely difficult to eradicate: the several strains of the fungal species have each exhibited imperviousness to major antifungal medications. This is troubling, as the fungus is particularly lethal for patients with immune systems already compromised by illness or age. The 90 day reported mortality rate is between 30 and 60 percent. An outbreak in Spain colonized in 372 people; caused infections in 85; and 35 (41%) died within thirty days.
The outbreak has led to public health officials scrambling to release information for health care providers, but also working to manage outbreaks quietly. Though the CDC operates a site with information for providers and consumers, and tracking the numbers of reported cases around the country, the CDC is not allowed to disclose locations of outbreaks. The US is not alone though, in that similar cloaks of secrecy exist in the UK and Spain, for example. Officials at Royal Brompton Hospital in London deemed there was “no need” to tell the public of a single appearance of the fungus despite its tenacious response to cleaning efforts. The interest here seems more interested in protecting hospital reputations than public health. One year after the initial outbreak at Royal Brompton Hospital, the hospital had fifty more patients struck. The hospital shut down its ICU for eleven days, and still made no announcement.
The rise of the superbug has started to create its own field of research. While there exists widespread awareness of antibiotic resistant bacteria, fungicidal resistant germs are not widely known. Suspicions have settled on the rise of bugs like *candida auris* related to overuse of antifungals in agriculture, similar to the rise of bacterial strains from overuse of antibiotics in livestock. *Candida auris* may itself be thousands of years old, and largely benign for much of its existence, but recent adaptations have caused it to proliferate aggressively.
The CDC reports that, as of the time of this writing, clinical cases have appeared in twelve states. We can expect further spread of the fungus. How hospitals and the CDC respond to the evolving threat waits to be seen. Research continues into the most effective ways to prevent, treat, and eradicate the fungus.
Read the New York Times article [here](https://www.nytimes.com/2019/04/06/health/drug-resistant-candida-auris.html). You can find the CDC website for the fungus [here](https://www.cdc.gov/fungal/candida-auris/index.html).
