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There is a long history of natural disasters that make people sick. Reports range from cases of Valley fever after the 1994 Northridge earthquake in California, which dumped dirt containing spores of Coccidia bacteria in the air, to aspergillus infections caused by the victims of the Japanese tsunami in 2011, raising bacterial water, to people infected and killed by fungi transferred to debris from Joplin, Missouri, tornado, also in 2011.
But it can be difficult to determine when an infection or reaction is specifically related to mold, because the damage caused by disasters exposes victims to so many substances. “After these floods or hurricanes, so many things happen: not only are you dealing with a house full of mold, but you’re tearing that house apart so there’s drywall and dust, plaster and all sorts of things we’re potentially breathing in,” he says. Tom Chiller, physician and head of the Mycotic Diseases Branch at the Centers for Disease Control and Prevention. “It’s hard to get rid of the mold effect.”
Thus, researchers are faced with a mystery: Their clinical instincts tell them that people are at risk, but they have a lack of data to prove it. Immunocompromised people are always at risk of mold and fungal infections; their reduced protection makes them unable to clear the fungal spores we all inhale every day, leaving them vulnerable to organisms such as aspergillus and ferocious mutant yeast. Candida auris. The CDC estimates that more than 75,000 people are hospitalized each year for invasive fungal infections and cost the health care system about $ 4.5 billion a year.
The most at risk are transplant patients who have received organ donors or have been treated for leukemia and are taking immune-suppressing drugs to support their recovery. Researchers say these people should not be near a moldy house, let alone work to remove it, and should stay away from floods. But in a study of 103 immunosuppressed patients by the CDC and several hospitals in Houston after Hurricane Harvey, half admitted to returning to clean their flooded homes, and only two-fifths of those said they wore protective respirator.
The CDC is working with some of these hospitals on a more complex post-Harvey project that has not yet been published, reviewing medical records from a year before and after the hurricane to see if immunosuppressed people have developed invasive fungal infections. with the storm. There is no clear signal in the data, says Mitsuru Toda, an epidemiologist at the agency’s branch of fungal diseases. increased and their number is small. “
Complicating this finding, she adds, some mold and fungal infections have incubation periods long enough that symptoms may not have appeared this year after the storm. In addition, Toda says, some doctors in Houston told the agency that they had preventively put their most immunosuppressed patients on antifungal drugs — which protect those patients — but would confuse all calculations about the hurricane’s effect on their health.
Ostroski-Zeichner was one of those clinicians. “In theory, we should see hordes of mold infections after major floods and hurricanes, but we don’t see that yet,” he said.
Researchers are also concerned about the much larger population, estimated at up to 40%, who are prone to allergies and could react to mold and fungal growths in their homes – as well as the rest of the population, which may develop new allergies. after exposure. “For most people, the health effects we see most often are respiratory,” said Felicia Rabito, an epidemiologist and associate professor at Tulane’s School of Public Health and Tropical Medicine. “A severe reaction would be like a breathing problem; a less severe reaction would be allergic-type symptoms. However, if you are asthmatic and the mold is triggered, you can cause an asthma attack, which is a very serious reaction. “
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