Attacking fungal infection, one of the world's major killers

December 23, 2013 by Rob Forman, Rutgers University
David Perlin of Rutgers' Public Health Research Institute says the battle against deadly fungal infection needs to be both better funded and more highly organized. Credit: Rob Forman

Ask someone what the term 'fungus' brings to mind, and chances are it will be an image of something that smells or looks disgusting. Ask David Perlin, executive director of the Public Health Research Institute at Rutgers New Jersey Medical School, and the response will be far more somber – because he knows how deadly fungi can be.

Fungal infections take more than 1.3 million lives each year worldwide, nearly as many as tuberculosis. Perlin has made it his mission to reduce the death toll and severe disability that fungi can cause.

"More than a million people around the world are blind because of fungal infections of the eye," Perlin points out, "and half of the world's 350,000 asthma-related deaths each year stem from fungal infection that could be treated effectively with drugs."

In addition, can complicate the recoveries of organ recipients. They also are the stuff of vaginal yeast infections, which strike nearly three quarters of American women at least once in their lifetimes according to the Centers for Disease Control and Prevention.

Fungi are neither bacteria nor viruses. Their biology is different from both, with a cell nucleus and other internal structures that distinguish them from their infectious distant cousins. But as Perlin is eager to tell anyone who will listen, they are just as big a threat to life and health.

"People know well what a bacterium or a virus can do," says Perlin. "We need to start thinking of fungi in the same terms, and part of that is becoming more aware that fungi are all around us in the environment. Yeast is a fungus. So is mold. Many people don't realize that."

A petri dish filled with Aspergillus fumigatus, a fungus responsible for death and serious illness among transplant recipients and people with asthma. Credit: Rob Forman

When at least 64 people died and more than 750 developed meningitis after their back pain was treated with tainted steroid injections in 2012, that, too, was caused by a fungus. During the manufacturing process, Exserhilum rostratum had contaminated those patients' medication. As an urgent response to that meningitis outbreak, Perlin co-led development of a test announced last January that can detect the fungus either in batches of medication or in the bloodstreams of people who are infected. Perlin and his colleagues had previously developed assays for other dangerous .

As he works in his lab on Rutgers' health sciences campus in Newark to unlock the many mysteries of fungal infection, Perlin is also trying passionately to improve the world's often disorganized approach to dealing with this deadly problem. In November, at an event in New York accompanied by a similar announcement at the House of Commons in London, he co-hosted the launch of GAFFI, the Global Action Fund for Fungal Infections. The organization's goals include both large efforts to accurately measure the scope of fungal infection around the world – much of which remains undocumented – and to implement relatively simple solutions where the problems are known but the will, the funding and the infrastructure to address them are absent.

For instance, the cause of fungus-related blindness may be as tragically simple as an irritation caused by an unclean finger. Diagnosis and treatment should be both easy and inexpensive, Perlin says, but are not available in many parts of the world.

Perlin adds that asthma caused by fungal infection is not just a problem of resource-poor countries. "There are people who needlessly suffer and die from asthma here in the developed world because there are physicians who haven't been trained to consider fungal infection as a possible cause," says Perlin. "When fungal infection damages lung function, many patients suffer for years for lack of proper treatment. That suffering is hard to accept because as many as 80 percent of people who receive appropriate drugs see their conditions improve. Many see their health completely transformed."

Fungi are not "sexy," which creates a competitive disadvantage when people like Perlin try to get the attention of governments, major foundations, the media and the public. But Perlin is convinced that getting noticed can translate into saving or improving millions of lives.

"It is tantalizing to know how much can be done if the right pieces fall in place," he says, "and I will keep doing both the science and the advocacy to help make that happen.

Explore further: A feline fungus joins the new species list

Related Stories

A feline fungus joins the new species list

June 18, 2013
( —A new species of fungus that causes life-threatening infections in humans and cats has been discovered by a University of Sydney researcher.

Evolution of an outbreak: Complications from contaminated steroid injections

June 19, 2013
A study of the patients who received injections of steroids contaminated with the fungus Exserohilum rostratum from the New England Compounding Center has found that some patients had fungal infections even though they did ...

Gene linked to deadly runaway fungal infection

October 21, 2013
For most people, a fungal infection like athlete's foot means a simple trip to the drugstore and a reminder to bring shower shoes to the gym. But in very rare cases, fungal infections can spread below the skin's surface and ...

Fungi offers new clues in asthma fight

February 19, 2013
Hundreds of tiny fungal particles found in the lungs of asthma sufferers could offer new clues in the development of new treatments, according to a team of Cardiff University scientists.

Unprecedented 'black mold' meningitis a challenge

October 25, 2012
(AP)—The black mold creeping into the spines of hundreds of Americans who got tainted shots for back pain marks uncharted medical territory.

Unraveling the largest outbreak of fungal infections associated with contaminated steroid injections

June 26, 2013
Investigators from the Centers for Disease Control and Prevention (CDC) describe pathologic findings from 40 case reports of fungal infection in patients who had been given contaminated epidural, paraspinal, or intra-articular ...

Recommended for you

Drugs that stop mosquitoes catching malaria could help eradicate the disease

September 18, 2018
Researchers have identified compounds that could prevent malaria parasites from being able to infect mosquitoes, halting the spread of disease.

Vaccine opt-outs dropped slightly when California added more hurdles

September 18, 2018
In response to spiking rates of parents opting their children out of vaccinations that are required to enroll in school—and just before a huge outbreak of measles at Disneyland in 2014—California passed AB-2109. The law ...

New evidence of a preventative therapy for gout

September 17, 2018
Among patients with cardiovascular disease, it's a common complaint: a sudden, piercing pain, stiffness or tenderness in a joint that lasts for days at a time with all signs pointing to a gout attack. Gout and cardiovascular ...

"Atypical" virus discovered to be driver of certain kidney diseases

September 14, 2018
An international research team led by Wolfgang Weninger has discovered a previously unknown virus that acts as a "driver" for certain kidney diseases (interstitial nephropathy). This "atypical" virus, which the scientists ...

Flu shot rates in clinics drop as day progresses, but nudges help give them a boost

September 14, 2018
Primary care clinics experienced a significant decline in influenza vaccinations as the day progressed, researchers from Penn Medicine report in a new study published in JAMA Open Network. However, "nudging" clinical staff ...

Rare antibodies show scientists how to neutralize the many types of Ebola

September 13, 2018
Two new studies by scientists at Scripps Research are bringing Ebola virus's weaknesses into the spotlight, showing for the first time exactly how human and mouse antibodies can bind to the virus and stop infection—not ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Dec 23, 2013
Mycoplasmas are now as widespread as the better known MRSA. I was wondering if the fact that MI and TN had the most cases of the contaminants can be explained? It would be hard to believe that people in those two states were somehow more susceptible, or that the shipments of steroids that went to those two states were conaminated as others were not.
In researching fungal infections, I have come to believe that these hard to id culprits are responsible for the symptoms we identify with sarcoidosis, the infection of the immune system.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.