The superfungus Candida auris, identified in three people in an interval of less than two weeks in Pernambuco, led the State Health Department (SES-PE) to intensify the hospital surveillance protocol. To GLOBO, José Lancart de Lima, general director of epidemiological information at the agency, reported that patients hospitalized with the disease are still stable.
read more:
None of them sought care for presenting any symptoms associated with the fungus. They already had some comorbidity, they went to the hospital and ended up finding out. But so far, all remain stable. When they are in conditions of release, they will be released – highlighted Lima. — There is no confirmation of death. We remain vigilant to ensure that cases are restricted to those already identified.
- The first patient diagnosed with White ears in Pernambuco this month was a 48-year-old man. The case was confirmed on the day may 11 and, since then, he has been interned at the Hospital Miguel Arraes, in Paulista;
- Em May 14th, a 77-year-old man was also diagnosed. He is hospitalized at the Hospital Tricentenario, in Olinda;
- This Monday, the 22nd, the scenario led SES-PE to suspend new appointments at Hospital Miguel Arraes, where the first patient was identified, to prevent the spread of the fungus;
- Already in the day May 23, another case was confirmed at the Hospital Português, in Paissandu, in the central area of Recife. The patient is a 66-year-old male.
what is known
In addition to Brazil, the microorganism has motivated alerts from health authorities in the United States. Resistant to common antifungals, White ears has a high fatality rate. Estimates indicate that 30% to 60% of those infected die from the disease. Despite this, Lima pointed out that the fungus is not a threat to the general public. The risks, he said, are greater when patients have comorbidities or need to undergo invasive procedures.
“That could be a gateway to systemic infection. This is the case of patients who are on mechanical ventilation or undergoing hemodialysis, for example – she clarified. — The main route of communication is prolonged contact with contaminated surfaces. This is not the case for quick contacts, such as a handshake. Generally, the fungus colonizes the skin surface of individuals. If it is found only on the outside of the body, there are no complications.
It was also in Pernambuco that the country recorded the largest outbreak of White ears, according to a recent study by the Oswaldo Cruz Foundation (Fiocruz). In all, 48 cases of the disease were identified between November 2021 and February 2022 in Recife, the highest number since the fungus was first confirmed in the country, in December 2020, in Salvador, Bahia.
At the time, the National Health Surveillance Agency (Anvisa) highlighted that the fungus “represents a serious threat to global health”. This is because some strains “are resistant to all three main classes of antifungal drugs and their identification requires specific laboratory methods, since White ears can easily be confused with other species.
Threat to public health
According to the US Centers for Disease Control and Prevention (CDC), the three main aspects that make the fungus pose a threat to public health are:
- Multirresistente. “Which means it is resistant to several antifungals commonly used to treat Candida infections. Some strains are resistant to all three available classes of antifungals”;
- Diagnosis. “It is difficult to identify with standard laboratory methods and can be misidentified in laboratories without specific technology. Incorrect identification can lead to inadequate management”;
- Dissemination. “It has caused outbreaks in healthcare settings. It is therefore important to quickly identify C. auris in a hospitalized patient so that health services can take special precautions to prevent its spread.”
What is the White ears?
A White ears was discovered in the world in 2009, in Japan. The exact origin of the fungus is still unknown. Researchers attribute the emergence and spread to climate change and global warming. In most cases, it affects people with compromised immune systems, such as the elderly and immunosuppressed, in hospital settings.
How is the transmission?
“The transmission mechanism within health services is still not fully known. Initial evidence suggests that it spreads through contact with contaminated surfaces or equipment in rooms of colonized / infected patients, therefore, it is essential to reinforce prevention and control measures with an emphasis on hand hygiene, cleaning and disinfection of the environment and equipment”, says the SES-PE document.
This Thursday, according to Lima, the SES created a state committee to fight the fungus. Composed of different areas of expertise, ranging from epidemiologists to biomedical, the objective is to promote discussions that can prevent the occurrence of new cases in Pernambuco. The agency also stressed that people who had contact with infected patients must undergo a period of surveillance.
O fungo mata?
The CDC also points out that nearly half of patients who contract White ears die within 90 days. But at the time of the alert, Meghan Lyman, a doctor of fungal diseases at the CDC, pointed out that one reason for the high lethality is that infected people are also dealing with other health problems, as they are often hospitalized for various reasons.
