The statistics are shocking — and you won’t have heard of them.
One in five patients admitted to intensive care with flu may contract a lethal fungal infection in their lungs called aspergillosis which can resist medicine’s best drugs.
Spores from this fungus are in the air all around us. They invade these patients’ lungs after an average of only three days in intensive care. And aspergillus kills nearly half of those it infects.
Most disturbingly of all, these victims are not the traditional prey of aspergillus fungus — vulnerable patients with failed immune systems — but young, otherwise robust people whose defences have been lowered temporarily by flu.
Did you know? One in five patients admitted to intensive care with flu may contract a lethal fungal infection in their lungs called aspergillosis which can resist medicine’s best drugs
So why haven’t you heard about this? The answer is that these statistics, published in the Lancet Respiratory Medicine journal in November, have been compiled by doctors at hospitals in Belgium and the Netherlands, where staff are extremely vigilant for aspergillosis.
In the UK, figures indicate a mere 0.2 per cent of all intensive care patients become infected with aspergillus.
Why the massive disparity? Experts warn it is not because Britain has fewer cases of aspergillosis. They say it is because UK doctors and pathology labs are failing to detect the fungus — not least because they aren’t looking for it.
When aspergillosis is detected in the UK, the diagnosis frequently comes too late — causing a mortality rate among severe flu patients nearly double that of our Dutch and Belgian counterparts. When it goes unnoticed, death is simply attributed to flu and associated complications.
‘It is entirely reasonable to assume that the real UK rates of infection are the same as in Belgium and the Netherlands,’ says David Denning, a leading authority on fungal disease who is professor of infectious diseases in global health at Manchester University, and runs the National Aspergillosis Centre.
He adds: ‘I am sure there are a lot of fungal infections in patients, but because professionals are not looking, they are not finding them.’
Aspergillus fumigatus, the fungus that causes the aspergillosis infection, is in soil, air, food and decaying organic material. It can form a grey, wrinkled cushion on damp walls and spreads via microscopic spores in the air.
When it invades a susceptible person’s lungs, it can grow into a lump the size of a tennis ball that can be difficult to eradicate. The infection can develop into invasive aspergillosis, which spreads from the lungs to the brain, heart, kidneys or skin. Its mortality rate can be as high as 90 per cent.
Risky: When Aspergillus fumigatus invades a susceptible person’s lungs, it can grow into a lump the size of a tennis ball that can be difficult to eradicate
Until recently, invasive aspergillosis was thought to afflict only people whose defences are laid waste by, for example, chemotherapy or a disease of the immune system such as Aids.
However, the Belgian and Dutch study shows that increasing numbers of otherwise healthy people are succumbing.
Indeed, late last year, the European Centre for Disease Prevention and Control issued a ‘rapid risk assessment’, warning that aspergillus infections in people with flu, but no underlying health problem, are increasing globally.
Last October, investigators at the U.S. Centres for Disease Control and Prevention reported that one-third of aspergillosis flu patients there are otherwise ‘healthy’.
The European risk assessment warns that doctors may miss such infections, because they don’t believe aspergillus can attack ‘healthy’ flu patients. As a result, they may die without clinicians noticing they had aspergillosis.
The report urged European authorities such as Public Health England (PHE) to ‘raise awareness about this issue among ICU (intensive care) physicians and clinical microbiologists’.
However, Professor Denning says PHE is neither monitoring the problem nor issuing warnings.
Professor Denning contrasts this with the vigilance in Belgian intensive care units: ‘Whenever a patient goes
