NJ Has More Soil Fungi Causing Lung Infections Than Previously Thought
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The CDC last revised its maps of disease-causing fungi in 1969, meaning doctors may have missed signs of fungal lung infection in patients.
by Josh Bakan, Posted Fri, Dec 2, 2022 at 2:11 pm ET
Soil fungi that cause significant, serious lung infections have been found in states long thought to be free of the threat, including New Jersey, according to a recent study from researchers at the Washington University School of Medicine in St. Louis.
Soil fungi that cause significant, serious lung infections have been found in states long thought to be free of the threat, including New Jersey, according to a recent study from researchers at the Washington University School of Medicine in St. Louis. (Shutterstock)
Climate change is likely the reason three main species of soil fungi that cause lung infections are spreading beyond traditional ranges to 48 of the 50 states and the District of Columbia, researchers said.
The species are:
Histoplasma, or histo, historically found in the Midwest and parts of the East;
Coccidioides in the Southwest;
Blastomyces in the Midwest and the South.
Researchers found cases of all three in New Jersey, despite outdated maps from federal health officials only showing histo in the Garden State. The CDC last revised its maps of disease-causing fungi in 1969, the researchers noted.
The soil fungi are disturbed and sent airborne by activities such as farming, landscaping and construction and even by people walking around in fungi-rich environments like caves.
Histo also grows well in soil that contains bird or bat droppings, according to the CDC, which said cleaning chicken coops also puts people at risk of a fungal lung infection.
The Washington University researchers said healthy people who breathe in the spores can fight off fungal lung infections handily but infants, older adults and people with compromised immune systems can develop fever, cough, fatigue and other symptoms that may be mistaken for bacterial or viral infections such as COVID-19, bacterial pneumonia and tuberculosis.
For years, the researchers said, physicians have relied on outdated maps from the 1950s and 1960s that showed the deadly environmental fungi were contained in certain geographic areas. In areas where the fungi weren’t thought to exist, doctors may have missed signs of fungal lung infection, resulting in delayed or incorrect diagnoses, the researchers suggested.
“Every few weeks I get a call from a doctor in the Boston area — a different doctor every time — about a case they can’t solve,” Dr. Andrej Spec, the study’s senior author, said in a news release.
“They always start by saying, ‘We don’t have histo here, but it really kind of looks like histo.’ I say, ‘You guys call me all the time about this. You do have histo,’ ” said Spec, an associate professor of medicine at the university and a specialist in fungal infections.
Lead author Dr. Patrick B. Mazi, a clinical fellow in infectious diseases at the university, said people with fungal lung infections often spend weeks trying to get the correct diagnosis and appropriate treatment, “and the whole time they’re feeling terrible.”
“They usually have multiple health care visits with multiple opportunities for testing and diagnosis, but the doctor just doesn’t consider a fungal infection until they’ve exhausted all other possibilities,” he said.
The findings are limited to fungal lung infections in Medicare recipients age 65 and older. The researchers analyzed Medicare fee-for-service claims from all 50 states and the District of Columbia from 2007 to 2016 to find out where soil fungi are sickening people today.
Of the 3,143 U.S. counties distributed across the majority of the United States, researchers found histo in 1,806 of them, Coccidioides in 339 and Blastomyces in 547 during the nine-year period of the study.
Researchers said 94 percent of states had at least one county with a problem with Histoplasma lung infections, 69 percent with Coccidioides and 78 percent with Blastomyces.
Researchers said their study raises awareness that fungal infections are more common than people realize and are spreading.
“The scientific community has underinvested in studying and developing treatments for fungal infections,” Spec said. “I think that’s beginning to change, but slowly. It’s important for the medical community to realize these fungi are essentially everywhere these days and that we need to take them seriously and include them in considering diagnoses.”
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