Chicago is one of a handful of American cities where infections have been reported of Candida auris, a deadly, drug-resistant fungus that’s spread around the world in the past decade, so far most affecting people in nursing homes and long-term care facilities. Here’s what you need know:
Chicago area is a hotspot for Candida auris.
Since May 2016, the Illinois Department of Public Health has logged 158 cases — 95 in Chicago, 56 elsewhere in Cook County and seven in DuPage, Lake and Will counties. That’s second only to New York and New Jersey, which together have seen more than 400 reported cases.
The “overwhelming majority” of Illinois cases have arisen at nursing homes and long-term, acute-care facilities, according to the state health department.
But state and local health officials have refused to release the names of Illinois health facilities with reported cases, saying that doing so would jeopardize patient privacy.
Most of those who’ve been infected had one or more of these risk factors: an IV, wounds, a feeding tube, urinary catheter, tracheostomy or ventilator.
The University of Chicago hospitals have had “a small number of patients in recent years” with the fungus, but the strains U. of C. encountered were treatable with antifungal drugs, according to a spokeswoman who said there has been no transmission to other patients or staff.
“Our chosen disinfection methods, which include the use of ultraviolet light and potent disinfection agents, have been evaluated, are effective and have been highlighted at national infectious diseases conferences,” the U. of C. spokeswoman said.
Nursing-home patients are especially vulnerable.
The state health department says the fungus “can cause bloodstream infections and even death, particularly in hospital patients and nursing-home residents with serious medical problems.”
Symptoms of invasive Candida infection include fever and chills that don’t improve after antibiotic treatment for a suspected bacterial infection, according to the federal Centers for Disease Control and Prevention. A lab test is required to properly diagnose Candida auris infection.
More than one of three patients who gets an invasive infection with the fungus — meaning, for example, it’s spread to their blood, heart or brain — will die, according to IDPH.
Candida auris is one tough organism.
The fungus — a type of yeast — can be resistant to antifungal drugs, especially if the infection isn’t caught in time. Once it enters a nursing-home patient’s room, it’s spread easily on surfaces including walls, doors and bedding and needs to be removed with special cleaning products.
Candida auris is hardy, too: It can survive on surfaces for a month or longer, according to the CDC.
Cook County has been surveying nursing home and long-term care facilities, testing individuals and room surfaces, according to Dr. Rachel Rubin, senior medical officer for the Cook County Department of Public Health.
When someone is found to be infected or to have had the fungus colonize on their skin with no infection, they need to be isolated from other patients and their room needs to be decontaminated, Rubin said.
Scientists are still learning about Candida auris, but it’s already known that people can have colonies of the fungus on their skin without any symptoms of infection.
“It’s true that a lot of people could be colonized,” Rubin said.
The infections have spread worldwide.
The earliest reported infection with Candida auris was in Japan in 2009. But some fungal samples collected before 2009 have since been identified as Candida auris, according to a report last year in the Journal of Intensive Care.
Over the past decade, the fungus has been discovered in countries in Asia, Europe, the Middle East, Africa, North America and Latin America.
Scientists don’t think it was one fungus that spread around the world, though. Gene sequencing leads them to believe at least four different types of Candida auris arose independently in different regions, according to the journal report.
And just as drug-resistant bacteria have evolved due to overuse of antibiotics and antimicrobial products, scientists say overuse of antifungal products is to blame, at least in part, for Candida auris’ swift rise.
Healthy people can help prevent the spread.
Even though most healthy people won’t get infected with Candida auris, taking simple, common-sense hygiene measures can help stall further spread of the fungus.
For example, when visiting a friend or relative in a nursing home or long-term care facility, people should avoid excessive touching of surfaces and wash their hands frequently.
Visitors should take note of whether staff are practicing good hygiene and making sure medical equipment is cleaned.
“The concern wouldn’t be that the [healthy] individual could get sick but that they could transfer it to someone else,” Rubin said.