‘The Last of Us’ in real life? Rising temperatures may spread fungal infections

One of the most suspenseful scenes in the HBO series “The Last of Us” comes in its pilot episode, when a scientist predicts that the end of the world will not come from a viral pandemic, but rather from a fungus. Cut to decades later – in the show, that is – and a dangerous fungus has mutated to turn most of the human race into monsters whose only drive is to spread the infection even further.

Of course, this is a work of fiction based on the hit PlayStation video game of the same name. (There’s also a similar plot in the 2014 best-selling novel “The Girl with All the Gifts,” which was adapted into a 2016 movie.) And many scientists on the HBO show note that the average temperature of human body of 98.6 degrees Fahrenheit is too much. hot for most fungi to survive in the human body.

But the show suggests that, if the world were to warm, then some potentially dangerous fungi could evolve to live in hotter environments, such as the human body. And that’s something that a growing body of real-world research suggests can happen in real life — though without creating hordes of zombie-like monsters in the process, of course.

According to the Centers for Disease Control and Prevention, about 7,199 people in the U.S. died from fungal infections in 2021, compared to only 450 such deaths reported by the CDC in 1969. More than 75,000 people are hospitalized in the U.S. each year with fungal infections. infections. And the number of deaths from fungal infections has increased during the COVID-19 pandemic.

In addition to the human cost, fungal infections also take a huge financial toll on the country, with direct medical costs estimated at $6.7 billion to $7.5 billion annually, according to the CDC. Indirect costs from missing work or school, or premature death are thought to be about $4 billion, with the total financial impact of fungal diseases in the US estimated to be at least $11.5 billion and up to $48 billion annually.

“As fungi are exposed to more sustained elevated temperatures, there is a real possibility that some previously harmless fungi will suddenly become potential pathogens.”

– Peter Pappas, infectious disease specialist at the University of Alabama

And Earth’s climate has warmed since the mid-1800s at a rate not seen before in the last 10,000 years. NASA notes that the planet’s average surface temperature has risen about 2 degrees Fahrenheit (1 degree Celsius) since the late 19th century, largely from increased carbon dioxide emissions from human activity, with the years 2016 and 2020 associated for the warmest year on record.

Meanwhile, deaths from fungal infections are also on the rise, according to research and fundraising organization Global Action for Fungal Infections, which reported that fungal infections kill more than 1.6 million people a year worldwide. The organization adds that more people die from fungal diseases than tuberculosis or malaria.

Additionally, a Duke University study published in the journal Proceedings of the National Academy of Sciences in January grew 800 generations of the fungus Cryptococcus deneoformans (which can cause severe infections in humans, especially those with weakened immune systems), revealing that higher temperatures may prompt these fungi to evolve faster in order to survive in hotter environments.

“As fungi are exposed to more sustained elevated temperatures, there is a real possibility that some previously harmless fungi will suddenly become potential pathogens,” Peter Pappas, an infectious disease specialist at the University of Alabama, told the Wall Street Journal. in Birmingham.

In other mushroom-related findings:

The World Health Organization published its first list of fungi threatening health last October. He singled out 19 “priority fungal pathogens” that he said represent “the greatest threat to public health” because they are becoming more common and more resistant to treatment. The WHO noted that these invasive fungal infections pose the greatest risk to critically ill patients and people with weakened immune systems, such as those with cancer, HIV/AIDS, organ transplants, chronic respiratory diseases and those suffering from infections. post-primary tuberculosis.

“Fungal infections are increasing and increasingly resistant to treatments, becoming a public health concern worldwide. ”

— Dr. Hanan Balkhy, WHO Assistant Director-General for Antimicrobial Resistance

“Emerging from the shadows of the bacterial pandemic of antimicrobial resistance, fungal infections are increasing and increasingly resistant to treatments, becoming a public health concern worldwide,” said Dr. Hanan Balkhy, WHO Assistant Director-General for Antimicrobial Resistance, in a statement. . The WHO report noted that fungal infections receive little attention and resources, so there is a lack of high-quality data on how many people suffer from fungal infections, and how fungi can develop resistance to scarce treatments. that are available.

Most people are familiar with antifungal medications that treat yeast infections, athlete’s foot, and ringworm. But the Food and Drug Administration has approved only four classes of antifungal drugs for invasive infections, notes The Wall Street Journal, and most of them are toxic, even at low doses. This is because fungal cells are more similar to human cells than microbes such as bacteria, so drugs that are toxic to fungi are also often toxic to humans. And there are no approved vaccines for the fungus.

So what can we do? The CDC notes that health professionals should continue to raise awareness of fungal diseases to increase early diagnosis and appropriate treatment. And public health officials must develop new systems and expand existing systems for surveillance and treatment of fungal diseases.

As for the rest of us, here’s a CDC list of the most common types of fungal infections in humans, including their symptoms and how they’re treated. Don’t panic – fungi are common in the environment and people breathe or come into contact with fungal spores every day without getting sick – but be aware that there are some people who may be at greater risk of becoming seriously ill. Learn about yeast infections so you and your doctor can recognize them early and hopefully get treatment before you suffer any serious complications.