Washington State Grapples with First Outbreak of Deadly Fungal Infection.
In a concerning development, Washington state is confronting its initial outbreak of a dangerous fungal infection, Candida auris, which has been on the rise across the United States. The number of cases has consistently increased each year since 2016, prompting experts to anticipate its eventual presence in every state.
This month, four individuals in Washington have tested positive for Candida auris, marking the state's first recognized outbreak. Health officials from Seattle and King County disclosed that one locally acquired case was identified in July, though no fatalities have been reported.
Candida auris poses a unique challenge as it is resistant to certain common antifungal medications and typically affects individuals with weakened immune systems. Hospital patients using catheters, breathing tubes, or feeding tubes are particularly vulnerable to this infection.
Three of the positive cases in Washington were patients at Kindred Hospital Seattle First Hill, a long-term acute care hospital. Routine screenings detected these cases before symptoms appeared, emphasizing the importance of early identification.
A fourth patient, previously cared for at Kindred, tested positive at a healthcare facility in Snohomish County, according to Seattle and King County health officials.
The health department revealed that the first case was reported on Jan. 10, followed by two more on Jan. 22 and a fourth on Jan. 26. Notably, all but one patient tested negative for Candida auris upon admission to Kindred, indicating that they likely contracted the fungus after entering the hospital.
While one patient developed an infection, the others were colonized with Candida auris, indicating they carry the fungus on their bodies without displaying symptoms. Those colonized still face a risk of developing infections.
Kindred Hospital Seattle First Hill assured that the affected patients are asymptomatic and have been isolated with extra precautions to prevent spread.
Candida auris was first identified in Japan in 2009, and since its reporting in the U.S. in 2016, cases have surged, with a 94% increase from 2020 to 2021. By December 2022, the fungus had been detected in 36 states, with over 5,600 recorded infections and an additional 13,000 identified through screenings.
The Centers for Disease Control and Prevention attributes the rise of Candida auris to increased screening, inadequate infection control, and prevention practices in healthcare facilities, exacerbated by staffing shortages and prolonged patient stays during the Covid pandemic.
Experts, including Dr. Peter Pappas from the University of Alabama at Birmingham, warn that the fungus will likely spread nationwide, raising concerns about effective control measures.
In Washington, the screening program at Kindred Hospital has played a crucial role in identifying cases early. Swabbing the armpits and groin – areas favorable for colonization – has been instrumental in this effort.
Dr. Arturo Casadevall from Johns Hopkins Bloomberg School of Public Health emphasizes the importance of active surveillance, noting that while disheartening, it provides a means to address the situation proactively.
While severe Candida auris infections have a mortality rate of 30% to 60%, healthy individuals typically remain unaffected. The public is reassured that active surveillance helps in containing the spread, even though the fungus can persist on surfaces for up to two weeks, making it challenging to eliminate once it enters healthcare settings.
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