EXCL: CDC’s fungal fighter reveals why the next pandemic could be a mutated fungus that causes skin pustules and brain swelling

It was the gruesome fantasy show that put mold on the map.

Based on the popular video game of the same name, The Last of Us saw a group of intrepid explorers make their way across a dystopian American landscape in search of a way to defeat the out-of-control fungus that was co-opting and altering billions of people’s brains. they turn into mindless, flesh-eating zombies.

While the real-world impact of mold outbreaks isn’t all that fantastic, there is more than a grain of truth to such a scenario, a top expert in the field told DailyMail.com.

According to CDC mold expert Dr. Ian Hennessee, the U.S. could soon experience an increase in new fungal infections that can block breathing, cause unsightly, painful boils on the skin or cause fatal brain swelling that ultimately results in death.

According to Dr. Hennesse, the Blastomyces species is among the most urgent threats, alongside Candida auris and valley fever-causing coccidioides. That’s why he has devoted most of his career to researching fungi.

Dr. Hennessee said, “The Last of Us brought the fungal diseases (to the forefront). These are often not the first things the doctor will think of.

“We encourage people to think about mold because these molds are out there. They are often rare, but when people do get them they are often misdiagnosed and underreported. And that can cause very serious diseases.’

Climate change makes the threat of widespread fungal diseases all the more realistic, as warmer temperatures and moist conditions mean species have longer to thrive and spread their spores each season.

The fungus that causes valley fever, coccidioides, thrives in hot desert environments that are now becoming increasingly hotter and drier. And another, Histoplasma, which causes histoplasmosis, thrives in wet soil on the East Coast, where more and more rain falls each year.

In the West, more people than ever are getting sick from Valley Fever, with cases in California tripling between 2014 and 2018 and between 2018 and 2022.

Meanwhile, Candida auris, a strain that has infected disease researchers like Dr. Of particular concern to Hennessee, about 2,400 Americans will die in 2022, up from 480 in 2019. Between 2013 and 2016, there were only 63 cases.

Blastomycosis, which results from inhaling the spores of the blastomyces fungus, is also becoming increasingly common. Last year Dr. Hennessee while investigating a massive outbreak at a Michigan paper mill that sickened more than 100 people and killed one person.

And earlier this year, researchers found evidence of more than 100 cases of blastomycosis in Vermont, where the blastomyces fungus is not normally found.

Dr. Hennessee told DailyMail.com that climate change has caused the fungus to expand its reach and hit new areas where it was not previously endemic, including Vermont. Developing drugs that outlast the fungi’s ability to evade them is critical to reducing the threat to public health.

He said, “As we see changing environmental conditions, we are concerned about the changing distribution, or even the impact of some of these fungal diseases, not just blastomycosis, some of the others, histoplasmosis, valley fever and things like that.”

In Michigan, 29-year-old Ian Pritchard became one of the first Americans of 2024 to succumb to blastomycosis, the second member of his family to die from it.

And in 2020, Ira Walker became infected. Ira spent a month in hospital after doctors surgically created an opening in his neck to his windpipe, before being transferred to a specialist facility for a higher level of care.

Although the hope was that he would regain lost strength and muscle mass, his situation only got worse.

His wife Lorelei told DailyMail.com: ‘Instead of regaining strength, he became weaker. Every time the hospital called, there was news of another setback.’

Blastomycosis is reportable in only six states, meaning the federal government does not have a good understanding of its exact prevalence.

When spores are inhaled, the blastomyces fungus undergoes a transformation into a type of yeast that becomes embedded in lung tissue and appears as opaque masses on X-rays. Because of this, it is often confused with pneumonia.

People with the infection may experience flu symptoms. In severe cases, they can progress within days to weeks to pneumonia, lesions on the skin (appearing as bumps, blisters, or sores), and neurological problems such as encephalitis or swelling of the brain.

The infection is not spread from person to person. Instead, the fungus infects people when they inhale its spores. It often hides in rotten wood and leaves.

Although it can be found in wood pulp that people process in the early stages of papermaking, cases of blastomycosis at the Michigan paper mill were not limited to that part of the mill.

Dr. Hennessee said, “There wasn’t a smoking gun or a single place where we could point to and say, everyone has it here and no one has it there.

“Instead, it kind of pointed us to, OK, could there be some kind of broad environmental exposure? Maybe people are exposed as they park and walk to the mill, which is next to a river.

He added that the spores could have been blown in, potentially causing illness at all stages of production.

Surveillance and warning efforts were extensive. Researchers like Dr. Hennessee ran around Escanaba, Michigan knocking on doors and asking people if they worked at the factory, or if they often hiked or rode ATVs in the woods.

He and fellow researchers from the National Institute for Occupational Safety & Health held town hall meetings with workers.

Ultimately, they told the workers to wear N95 respirators.

Deadly fungal diseases have become increasingly common recently, from 4,746 cases in 2018 to 7,199 in 2021. And climate change seems to be the driving force behind this.

Dr. Hennessee said: ‘We could see it in areas outside its historically endemic range. We’ve never seen it in a large industrial setting before (the Michigan outbreak), so it’s possible that we might see it at times in other areas where we just didn’t see that.”

He added: “But testing for it is limited. Its testing is limited. We don’t have good environmental samples. And it’s not always easy to say, Hey, is it in a new place? Or do we just look for it in this new place?’

A 2022 report found that about 10 percent of blastomycosis cases are diagnosed in areas other than where the fungus thrives, as warming temperatures expand their endemic range.

A deadly combination of international travel and climate change is making infections more common.

In Vermont, where winters are very cold and springs and summers are mild, it has become milder and milder over the past decade, allowing non-native fungi to thrive.

Dr. Hennessee said: “We are certainly concerned because the temperature is changing and the environmental conditions are changing. And a lot of the fungi that we’re working on, including Blastomyces, are certainly very climate sensitive or sensitive to changes in temperature, rainfall and things like that.

“The work from Vermont is a good example, where we see it being detected in areas outside of what we thought was its historical range.”

Blastomycosis is much less common and is not transmissible like another troublesome disease-causing fungus, Candida auris.

C. auris kills about one in three people who become infected. It is resistant to most antifungal infections, making it a major concern for disease researchers.

The yeast is highly transmissible and spreads easily by touching contaminated surfaces among immunocompromised patients.

Infections can cause potentially fatal sepsis. It is primarily a health care problem and rarely a problem for the general population.

Dr. Hennessee said: ‘It can cause more types of healthcare-related outbreaks and it can spread quite quickly. And it is often very resistant to medications.

“We’re concerned about that, and it’s spreading quite quickly worldwide, especially in healthcare.”