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‘Worsening spread’ of deadly fungal infection raising alarm in U.S.

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Cases of a drug-resistant infection caused by the fungus Candida auris are on the rise in the United States, according to new data from the Centers for Disease Control and Prevention (CDC). The fungal infection has proved deadly, especially for those with compromised immune systems, and has demonstrated an ability to spread easily in health-care settings.

The CDC data was published Monday in the Annals of Internal Medicine, amid an outbreak of fungal infections in long-term care facilities in Mississippi. The U.S. health agency found that cases of C. auris increased 95 per cent from 2020 to 2021 following a 44 per cent increase the year prior.

Preliminary figures estimate that there were 2,377 active C. auris infections across the U.S. in 2022, with 5,754 “colonization” cases. A colonization case denotes when a person has evidence of the fungus in their body without signs of an active infection.


Map showing the distribution of C. auris infections in the U.S. in 2022.


CDC

C. auris, a type of yeast that can infect the bloodstream, is resistant to multiple anti-fungal drugs and is estimated to kill about 40 per cent of people who become infected, according to Health Canada. Even when patients survive, they can remain “colonized” with the fungus for years after treatment, the CDC says, and potentially pass it along unsuspectingly.

These fungal infections are of most concern to people who have been hospitalized for long periods of time, are at high risk of infection, or have medical implants. The organism often causes no symptoms in healthy people.

C. auris was first detected in the U.S. in 2016, though case numbers remained low until the “dramatic increase in 2021,” the CDC report reads. The fungus was first discovered in 2009 in Japan and has since caused outbreaks in numerous countries around the world.

Rising cases of C. auris infections, “especially in the most recent years, are really concerning to us,” said the study’s lead author, Dr. Meghan Lyman, chief medical officer in the CDC’s Mycotic Diseases Branch. “We’ve seen increases not just in areas of ongoing transmission, but also in new areas.”

“There’s still a lot to learn about colonization patterns,” Lyman said. “While (medicine) may treat the infection, we don’t have evidence that it completely eliminates C. auris from their body.”

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Between 2012 and 2021, there were 31 cases of C. auris found in hospitalized patients in Canada, according to data from the National Microbiology Laboratory and Canadian Nosocomial Infection Surveillance Program.

The CDC’s warnings come as Mississippi battles an outbreak of the fungus.

At least 12 people in the state have been infected with the fungus with four “potentially associated deaths,” said Tammy Yates, spokesperson for the Mississippi State Department of Health. Both those numbers doubled since an earlier update on the outbreak in January. The first cases were noticed in the state last year in November.

Transmission of the infections occurred in two long-term care homes, with Yates noting that “multi-drug resistant organisms such as C. auris have become more prevalent” in such facilities and among “highest risk individuals.”

The World Health Organization ranked C. auris as one of the worst fungal threats facing humanity today, given its high mortality rate and resistance to treatment. Recent research suggests that serious fungal infections as a whole affect 300 million people worldwide and more than 1.5 million die from them each year.

Dr. Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York, said that the new CDC data on C. auris is “worrisome.”

“But we don’t want people who watched The Last of Us to think we’re all going to die,” Javaid said. “This is an infection that occurs in extremely ill individuals who are usually sick with a lot of other issues.”

Global News has reached out to Health Canada for further comment on the current status of C. auris infections in the country.

 

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Some Ontario docs now offering RSV shot to infants with Quebec rollout set for Nov.

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Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.

The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.

Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.

Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.

Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.

The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.

This report by The Canadian Press was first published Oct. 21, 2024.

-With files from Nicole Ireland

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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Polio is rising in Pakistan ahead of a new vaccination campaign

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ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.

Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.

The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.

Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.

Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.

The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.

Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.

The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.

Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.

The Canadian Press. All rights reserved.

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White House says health insurance needs to fully cover condoms, other over-the-counter birth control

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WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.

Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.

The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.

“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”

The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”

Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.

If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.

Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.

The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.

The Canadian Press. All rights reserved.

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