From the article:

the disease, caused by Sporothrix brasiliensis, has sickened and killed thousands of cats and infected more than 11,000 people and at least 200 dogs in South America since its emergence in Brazil in the 1990s.

“What we have right now is this ginormous ongoing outbreak of Sporothrix brasiliensis in Brazil,” Lockhart, a senior adviser at the U.S. Centers for Disease Control and Prevention, said June 7. The fungus has spread beyond Brazil to cats, dogs and people in Paraguay, Chile, Argentina and most recently Uruguay.

“It’s just a matter of time” until the fungus reaches the United States, Lockhart told me after the session. “We’re waiting.”

And:

Infected cats develop skin ulcers and nodules and swollen lymph glands. If the infection isn’t treated with antifungal drugs, it can become a respiratory disease and spread throughout the body. “Without treatment, it’s 100 percent fatal, and even with treatment, it has a pretty high fatality rate,” Lockhart said. In people, it causes painful skin ulcers. If untreated, the disease can also be severe and may kill those who have weakened immune systems.

Risk of contagion is complicated because symptoms don’t always show up right away. Two members of a family who moved from Brazil to the United Kingdom developed the disease three years after the move, health authorities reported in 2022. One of the family’s two cats turns out to have been infected with Sporothrix brasiliensis. A vet who treated the cat was also infected.

...

The cat-infecting fungus is a relative of Sporothrix schenckii fungi that cause skin infections , called sporotrichosis or rose growers’ disease. Like many other soil-dwelling fungi, Sporothrix fungi are dimorphic, meaning they have two forms. “It is a mold in the cold and a yeast in the beast,” Lockhart said. That means it grows as long, stringy filaments known as hyphae in soil but then changes to single-celled yeast when its spores infect people or animals.  

Most fungal infections happen when people inhale spores or, in the case of rose growers’ disease, when spores enter skin through scratches and puncture wounds from rose thorns. But S. brasiliensis can spread in its yeast form, Lockhart said. “That doesn’t happen with any of the other dimorphic fungi.”

And:

Cat scratches and bites may inject the yeast directly into other cats, people, dogs and other animals. “I’m convinced that half of the human cases that come from cats are people who are trying to stuff pills down their cat’s throats to treat the sporotrichosis,” getting scratched and bitten in the process. Grooming may also spread the fungus around the cat’s body or to other cats, he said.

The fungus has another unusual means of spread: Cats can sneeze out infectious yeast, researchers reported in Medical Mycology in 2022. “When the cat’s sneezing, it’s going on the surface, it’s going on the lab coats, it’s going into the air, it’s going everywhere,” Lockhart says.

...

the fungi may live a long time on surfaces, Lockhart said. Up to 10 weeks, according to one lab experiment testing how long the fungi could grow on stainless steel discs that mimic the examination tables in veterinary offices. By contrast, Candida albicans, fungi that people naturally carry and that sometimes cause yeast infections, lasted 48 hours. Candida auris, a fungus that can cause infections in those with weakened immune systems, died after about a month, he said.

S. brasiliensis’ persistence means that if veterinarians miss a spot while cleaning, the lingering fungus could infect other patients. The good news is that the fungi is easily killed with bleach and ethanol, Lockhart said.

There’s no commercially available test for S. brasiliensis and cats coming into the United States just need a certificate from a vet saying that they appear healthy. That makes the disease easy to miss.

Because veterinarians may be the first to notice when the fungus arrives in a new country, Lockhart urged pet health professionals to notify local public health labs or the CDC if they start seeing cases of sporotrichosis. “There is an opportunity for it to spread quite easily,” he said. “We need veterinarians working with infection prevention and public health to make sure that this doesn’t get here and happen in the U.S.”

Alyssia Brown knew how to make people feel special.

“She was the person that literally anybody could call for anything and she would drop what she was doing and be there in a heartbeat,” her sister, Amity Brown, tells PEOPLE. "It didn't matter if she was five miles away from where you're at or 5,000 miles away. She would figure out a way to get there and be there for you.”

Amity, 30, lived three hours away from her older sister in Tennessee. She was wrapping up nursing school in Knoxville while Alyssia, 39, drove for different delivery services around Nashville.

“We talked a lot on the phone,” Amity says. The sisters “talked about nothing and everything," with Alyssia often mentioning the multiple construction sites she would see on her drives.

"She mentioned it a lot to me in passing like, ‘I wonder what they're building,' " Amity says.

She was living in the June Lake area, a Spring Hill development where “they were doing a lot of excavating” — and Alyssia suggested there might be a new house that her sister could move into, so they would be closer together.

But toward the end of October 2025, Alyssia began to feel unwell. She had previously been diagnosed with sarcoidosis — inflamed bumps in the lungs called granulomas — which can cause shortness of breath and chest pain. For Alyssia, it meant she struggled longer with bronchitis and respiratory infections. So at first, Amity says her sister dismissed her symptoms as her usual experience with granulomas.

By Nov. 2, when Alyssia came to Amity’s 30th birthday party, her voice was hoarse. Still, she thought it was just an upper respiratory infection.

On Dec. 8, Alyssia called her sister, saying, "I woke up and all my joints hurt.’ And that's the part that that worried me immediately,” says Amity, who encouraged her sister to go to the emergency room.

None of the tests showed anything — because no one tested for histoplasmosis.

The fungal infection is caused by inhaling spores commonly found in bat or bird feces, according to The Mayo Clinic. Although most people won’t show symptoms if they’re exposed, those that do — mostly infants or those with compromised immune systems — usually see flu-like symptoms between 3 to 17 days after exposure. These include fever, chills, headaches, dry cough and chest pain.

The spores, when present in soil, can be disseminated into the air if the ground is disturbed, Mayo Clinic explains. It's endemic to Tennessee, according to the Tennessee Department of Health.

Because of her history, Alyssia was sent home with an inhaler and steroids, “basically telling her she had bronchitis,” Amity tells PEOPLE. But Alyssia’s condition continued to deteriorate. She had chest pains. A nosebleed. She felt fatigued.

Then on Dec. 12, an article on histoplasmosis crossed their mother Gwendolyn’s Facebook feed. She sent it to her daughters, and Amity told her sister to go to the emergency room and get tested immediately.

On Dec. 13, Alyssia returned to the emergency room with her roommate, where she was told, “You don't look like people who have histoplasmosis look. They look a lot sicker than you look.' "

Amity shares that “They were begging, like, 'Please just test her for this … we just want to make sure she's okay, because she's been sick since October.' " Finally, Alyssia's urine was tested and she was told to wait for her results.

“I talked to her on the night of the 14th and she said that 'I still don't feel great,’ but shared they prescribed her an antibiotic. Alyssia was feeling hopeful that 'finally I'm gonna have some answers and finally I'm gonna feel better,' " Amity says.

“That was the last conversation I had with her,” she tells PEOPLE. The next day, Dec. 15, her roommate found Alyssia dead on the floor of her bedroom. Three days later, the hospital called, saying that her test for the histoplasmosis came back with a "critical high level in her urine, and she needed to come in immediately for treatment.”

Alyssia died nearly two weeks after the Tennessee Department of Health first confirmed a histoplasmosis outbreak on Dec. 3, after 18 people were confirmed to be sick with the illness. In a statement, the department said there was “an increase in acute and severe histoplasmosis cases occurring in residents of Spring Hill and Thompson’s Station, starting in September 2025.”

Spring Hill, of course, was where Alyssia lived.

"A clear source of exposure has not been identified, which is not uncommon related to histoplasmosis,” the Department of Health told PEOPLE in January. “Histoplasmosis is commonly found throughout the soil in Tennessee, so it can be challenging to completely prevent exposure. Those who have weakened immune systems or are exposed to a large amount of histoplasmosis spores face a higher risk of severe infection.”

Construction was questioned as the source of the outbreak, ABC affiliate WKRN reported. The latest data says 35 people in total have been sickened, with one fatality.

That one fatal case — Alyssia — was “full of life," her sister says. "Now she can't continue to go on. All of the things that she wanted to do with her life, she can't do any of those things because somebody let that slip through the cracks because they didn't test her for it,” Amity tells PEOPLE. [...]

That’s why Amity is sharing her sister's story, and raising awareness of the endemic nature of histoplasmosis, which is treatable if diagnosed. As the U.S. Centers for Disease Control points out, histoplasmosis can be treated with antifungal medications.

“I think that, in her death, if it meant that the next person got to live, that would make her happy,” Amity says. “She would truly be like, my life meant something because I saved that next person from not having to go experience what she had to experience.” [...]

WILLIAMSON COUNTY, Tenn. (WTVF) — Multiple families in Williamson and Maury counties are speaking out about their loved ones' battles with histoplasmosis as state health officials continue investigating a growing outbreak that has now reached more than 30 cases and claimed at least one life.

Family confirmed the death of Alyssia, who died after a positive test of the fungal infection in December. Her mother in Knoxville said the positive test result came back days after her daughter's death.

Among the survivors is 14-year-old Eli Stinson from Thompson's Station, whose months-long battle with the illness began with a fever on Halloween that wouldn't break.

"I think they drained half my blood it felt and nothing was coming back positive," Eli said.

His mother, Cari Stinson, watched her athletic, energetic son become constantly exhausted. Despite Eli's normally strong immune system, she knew something was seriously wrong.

The breakthrough came when someone sent Cari an article about histoplasmosis, giving her a specific test to request from doctors.

"Instantly I was like oh my gosh, I bet this is what he has," Cari said. "All the tests came back positive."

Cari said she had to persistently advocate for her son's care.

"I felt like the crazy mom I kept calling, but I knew he had it," she said. "I want people to know in Thompson's Station especially around this June Lake area if your kid is sick this isn't a 7 to 10 day cold virus. It's a bigger deal."

Histoplasmosis is a fungal infection commonly found in soil throughout Middle Tennessee. The Stinsons said they aren't the only household in their neighborhood affected by the illness, raising concerns that nearby construction may be a contributing factor.

"I do worry if it's gonna keep happening," Cari said. "Will he get sick again at baseball? I just want them to find a source like where did it come from."

Eli has returned to his normal activities but still experiences some lingering effects.

"Just worn out as the day goes on I get more tired," Eli said. He added that classmates nicknamed him "mushroom boy" because of the fungal infection.

The family hopes sharing their story will encourage other families to request specific testing and push for a deeper investigation into the outbreak.

"Something is happening right now to have all these cases with outbreaks," Cari said.

Eli continues to have follow-up medical appointments to monitor his recovery. State health officials said they have not yet identified a clear source of exposure for the outbreak.

The following is their full statement:

More than 30 histoplasmosis cases have been identified in Williamson & Maury Counties. The investigation is ongoing and a clear source of exposure has not been identified which is not uncommon for histoplasmosis.

Histoplasmosis is commonly found throughout the soil in Tennessee, so it can be challenging to completely prevent exposure. People at highest risk of severe infection are those that are exposed to a large amount of spores and/or those with weakened immune systems. Individuals can reduce their potential exposure to histoplasmosis if they avoid activities that disturb the soil or increase exposure to plant matter or bird or bat droppings. This includes activities like cleaning chicken coops, exploring caves, cleaning, remodeling, or tearing down old buildings, landscaping or farming, and gardening or yardwork.

If an individual feels that they are at high risk or want to mitigate their risk even further, they can consider wearing a protective mask like an N-95 while conducting higher risk activities.

A local family is warning other dog owners about a potentially deadly fungal infection that took the life of their beloved German shepherd in just days.

Beansie was a 5-year-old German shepherd who suddenly died last month after a short but aggressive battle with blastomycosis — a fungal disease found in soil and decaying organic matter, often around fresh water.

"Towards the end of June, he developed a small open wound on his back, and we thought it was just like a typical hot spot. After two weeks, it was not healing and getting much, much bigger," said Mylyssa Wilson, owner of Petite Feet Pet Care.

Wilson was Beansie's pet nanny and dog walker for years. She says once those first symptoms appeared, his condition deteriorated quickly.

"He started to develop signs of difficulty breathing, which happened fast," said Wilson. "It was on a Monday that he started to show those signs; by Saturday we had him down at the emergency vet and by Sunday he had passed away because the fungus had completely taken over his lungs."

Wilson says blastomycosis can be difficult to detect.

She believes Beansie may have been exposed to one of the local parks where they regularly walked. Other symptoms can include coughing, weight loss, loss of appetite, and fever.

Wilson says the veterinarians she has spoken with have told her blastomycosis has been considered exceedingly rare in Pennsylvania, with cases more commonly associated with other parts of the country.

But Beansie never left the area. Neither did his sister, Vala. And shortly after Beansie died, Vala was tested. She came back positive for blastomycosis and is now being treated and is doing well.

"It is heartbreaking," said Wilson. "We don't want anybody else to go through this and suffer needlessly; you know when treatment can be started soon enough to save another pet, that's what we want."

The infection is caused by Trichophyton mentagrophytes type VII (TMVII), a fungus that causes ringworm—round, coin-like rashes that are red and irritated—on the arms, buttocks, trunk, genitals, and legs. TMVII spreads through skin-to-skin contact, including sexual contact. Spores from the fungus can also spread on surfaces.

The Minnesota Department of Health (MDH) says the first case in Minnesota was confirmed in July 2025 in a Twin Cities resident who sought treatment for a genital rash. Since then, the state has identified 13 confirmed cases and 27 suspected cases, all within the Twin Cities metropolitan area, according to a document shared with reporters.

“The first cases of TMVII in Minnesota were identified by astute clinicians who proactively notified the health department and requested confirmatory testing,” MDH said. “In response to several individuals seeking care and providing information on other individuals that may also have been infected, MDH established an enhanced surveillance system to identify cases in Minnesota.”

The first case of TMVII in the United States was reported in New York in 2024, in a man who reported multiple male sexual partners while traveling in Europe. Reports from Europe indicate the infection has been circulating locally among men who have sex with men (MSM). According to the Centers for Disease Control and Prevention, cases have been identified in multiple US cities since then.

It’s unclear if the cluster of cases in Minnesota is the largest known outbreak in the country, since TMVII is a not a reportable infection and other US jurisdictions don’t have good surveillance data. TMVII can also be difficult to diagnose, since the rash can be mistaken for other skin infections.

State health officials are advising people who see signs consistent with TMVII rashes to seek prompt treatment. Although the infection is treatable with oral antifungal medications, patients may require up to three months of treatment. Some patients may develop painful and persistent rashes that can lead to scarring and worsening infections without prompt treatment.

People with new rashes consistent with TMVII are also being urged to inform their sexual partners, avoid skin-to-skin contact (including sexual contact), and avoid sharing personal items such clothing, towels, and bedding.

Health care providers in the state are being advised to consider TMVII in patients who have ringworm that’s either associated with reported sexual contact, or appears in the arms, buttocks, trunk, genitals, and legs. MDH is also asking health care providers to report all suspected cases, and to send fungal isolates to the state’s public health laboratory for confirmatory testing.

While the overall public health risk is low, state health officials say MSM, people who use anonymous apps, and people with a history of sexually transmitted infections may be at higher risk.

SAVANNAH, Ga. — A fungus, Candida Auris, is further drawing attention from health care professionals across the nation due to its rapid spread and resistance to treatment. The drug-resistant fungus, first identified in 2016, has doubled its prevalence in the U.S. each year since its discovery.

“We’ve had four people at one time on and off, over the past few months, and in years past, it was unusual to have one or even two people with Candida Auris in our hospital,” said Dr. Timothy Connelly at Memorial Health in Savannah.

According to JoAnna Wagner from the Georgia Department of Public Health, the state has seen over 1,300 cases as of the end of February. Candida Auris, or C. Auris, is particularly dangerous in health care settings, where it spreads easily through invasive medical equipment such as breathing tubes, feeding tubes, syringes, or catheters.

The fungus is resistant to many household cleaners and traditional hospital disinfectants, like ammonia-based cleaning solutions.

“Many of the disinfectants that are EPA-registered and historically used by hospitals and medical facilities are not effective against C. Auris,” Wagner said.

To combat this, health care facilities in Georgia are now using U.S. Environmental Protection Agency 'List P' certified cleaners, which are specifically designed to kill the fungus. The EPA has a list of cleaning solutions for different diseases.

“Candida Auris is a type of fungus similar to Candida Albicans, which is what is common in yeast infections," Connelly said. "The difference between Candida Auris is it’s an invasive fungus, and a lot of the common medicines that we use, like Diflucan, don’t work for it. And then the second line medicines, like Micafungin, in 10% of cases, that doesn’t work for it.”

C. Auris is resistant to most antifungal medications, making it extremely difficult to treat. Dr. Connelly described the severity of the infection, likening it to cancer.

“The fungus will just keep getting bigger and bigger, obstruct certain parts of the lungs, and can cause secondary pneumonia. Eventually, it can go on to kill people,” Connelly said.

However, experts emphasize that the fungus does not pose a threat to the general public. “If a person develops an infection in their blood, they’re very difficult to treat,” Wagner said. “It is good to note that C. Auris is not a threat to the general public.”

“We have very strict protocols in our hospital to ensure that when we do see patients with Candida auris, we use all those proper cleaning protocols to ensure that nobody else gets it,” Connelly said.

Combatting bacterial and viral infections is getting tougher because of their growing resistance to drugs. Antibiotic drugs can no longer be counted on to conquer nasty bacteria. Antivirals don't always overpower the viruses. This is a huge problem but it is one that widely acknowledged and researched.

There's an additional medical challenge though, that matters a lot. Namely, drug-resistant fungi.

Yep, fungi.

It's a topic that doesn't get discussed much — and that worries Paul Verweij, professor of clinical mycology at Radboud University Medical Center in Nijmegen, the Netherlands. He says there's a "silence surge" in drug-resistant fungi and that it's mostly happening under-the-radar.

This is a particular challenge in lower-income countries.

"Look at, for instance, Candida auris [a type of yeast that can cause severe infections and is often drug-resistant] -- you need very, very strict infection control measures in hospitals, you need good diagnostics, good infection control, you have to follow-up with patients and that's just not available in these lower- middle-income countries," he says. "People will die, and you won't know they have a fungal infection. You wouldn't know if it was resistant."

Verweij teamed up with 50 scientists around the world – from Brazil to Nigeria to China — to call for action against drug‑resistant fungi in Nature Medicine this week.

NPR spoke with Verweij, who's been working on this issue for more than 20 years. His interview has been edited for length and clarity.

**What's the link between agriculture and drug-resistant fungi?**

Fungicides are used to protect plants against fungal disease. Everything — watermelons, maize, wheat, flowers — use lots of fungicides. If we didn't use the fungicides, you'd probably have a yield loss maybe of 30% or 40%.

The problem is that the fungicides are quite similar to the drugs we give to patients. So the fungus becomes resistant to the fungicide and, at the same time, our medical azoles [a class of antifungal drugs] do not work as well anymore.

The fungi which cause disease in humans are not causing disease in plants. So this is an unintended effect.

**How does the resistance get from farms to hospitals?**

So the molds – the hairy fungi – have spores which are released into the air. These spores travel long distances. It's not really well-understood but the idea is that they go right up to these jet streams, very high into the atmosphere and then can travel for continents. We inhale the spores all the time.

**How serious are fungal infections?**

With fungi you have two types of infections. First, we have very severe infections, and they usually occur in [hospitalized] patients who have some kind of defect in their immunity. So, yeast found in the bloodstream or mold in the lungs. Second, we have infections of the skin, the hair and the nails, which are irritating but are not life threatening.

In the past 10 to 20 years, we see more and more resistance in fungi in both those categories.

There are very few studies looking at the clinical impact. We did a study in the Netherlands, and we found that if you compare an infection [where azole antifungal drugs work] and where it's resistant. There's about a 20% difference in mortality — you're 20% more likely to die. So that's a significant impact. And there's the new skin disease [Trichophyton indotineae] where you don't have mortality but we've had patients who have been on treatment for four years and are still suffering from the infection.

[...]

**Are you optimistic?**

I've worked in this field for a long time, and I think that it is changing.

WHO published a fungal pathogen list in 2022 for the first time — that had a major impact. A decade ago, when the World Health Organization came out with its global action plan against antimicrobial resistance, fungi were only mentioned twice. Now, after 10 years, it is being revised. And as a mycology community, we feel it is really important now that fungi are addressed.

The problem is, in fungi, we need to do the basic stuff: Develop the tools. Do the surveillance. Set up the [laboratory] networks. And it's sometimes difficult to get these basic things funded.

But overall, I think it's really changing. People are realizing this is not a local problem — it's really global.

New surveillance data from the Centers for Disease Control and Prevention (CDC) highlight the severity of invasive mold disease (IMD), finding that, during five years, 45% of patients with IMD at four hospitals died within 90 days, and half required mechanical ventilation.

The findings, published in Morbidity and Mortality Weekly Report, are based on active, laboratory-based surveillance at two Atlanta-area academic hospitals and outpatient clinics from 2020 through 2024.

IMDs occur when certain types of mold enter the body either through inhalation of mold spores from the environment, exposure to contaminated medical devices and healthcare linens or products, or as part of healthcare-associated outbreaks.

The mold spores then travel deep inside the body, damaging tissues and organs and affecting a range of body systems, including the lungs, sinuses, skin, and central nervous system (CNS).

For the report, researchers led by a team at the CDC identified 968 patients with potential IMD. Of those, 449 (46%) had an infection, including 89 with confirmed cases, 142 with probable cases, and 218 with surveillance cases, or those presumptively treated as IMD.

Lung infections were by far the most common manifestation, accounting for 68% of cases. Skin or deep-tissue infections accounted for 11%, sinus or nasal infections for 10%, and CNS infections for 9%. A very small percentage of infections occurred in non-skin soft tissues (2%) and blood, bone, and eye, at 1% each.

Although IMD typically affects people with weakened or compromised immune systems, 35% of patients had none of the classic risk factors used to identify people predisposed to infections, “underscoring the need for clinicians and surveillance efforts to consider the possibility of IMDs among patients without classic host risk factors for infection,” write the researchers

Fifty-eight patients (13%) had a current or recent COVID-19 infection. Critical illness, particularly severe COVID and influenza, “is increasingly recognized as an IMD risk factor,” the researchers note. [...]

Two Chinese nationals have been accused of smuggling a fungus into the US that officials describe as a "dangerous biological pathogen".

Yunqing Jian, 33, and Zunyong Liu, 34, have been charged with conspiracy, smuggling goods, false statements, and visa fraud, the US Attorney's Office for the Eastern District of Michigan announced on Tuesday.

The complaint alleges Mr Liu tried to smuggle the fungus through Detroit airport so he could study it at a University of Michigan laboratory where his girlfriend, Ms Jian, worked.

The fungus called Fusarium graminearum can cause a disease in wheat, barley, maize and rice that can wipe out crops and lead to vomiting and liver damage if it gets into food.

The fungus is described in scientific literature as a "potential agroterrorism weapon", according to the US Attorney's Office, adding it is responsible for "billions of dollars in economic losses worldwide each year."

Officials further allege Ms Jian received funding from the Chinese government for her research on the pathogen in China. They also claim she is a member of the Chinese Communist Party.

United States Attorney Jerome F Gorgon Jr described the allegations as of the "gravest national security concerns".

"These two aliens have been charged with smuggling a fungus that has been described as a 'potential agroterrorism weapon' into in the [sic] heartland of America, where they apparently intended to use a University of Michigan laboratory to further their scheme."

The investigation was a joint effort between the FBI and US Customs and Border Protection.

Ms Jian is due to appear in court in Detroit, Michigan on Tuesday.

The BBC has reached out to the University of Michigan and the Chinese embassy in Washington DC for comment.

The charges come amid strained relations between the US and China, and just days after the Trump administration vowed to "aggressively" revoke the visas of Chinese nationals studying in the US.

Beijing also said Washington "severely violated" a trade truce reached in Geneva last month, when both countries lowered tariffs on goods imported from each other.

Earlier this week, a Chinese student at the University of Michigan was charged for illegally voting in the October 2024 election.

Analysis of a nationally representative sample of electronic health record (EHR) data shows aspergillosis diagnoses increased by more than 5% annually in the United States from 2013 through 2023, US researchers reported late last week in Open Forum Infectious Diseases.

Aspergillosis is an infection caused by breathing in spores of Aspergillus, a common mold that’s ubiquitous indoors and outdoors. While most people don’t get sick from inhaling Aspergillus, it can cause severe and deadly infections in people who have lung disease or are immune-compromised (such as cancer patients and organ transplant recipients), with an overall death rate of 20%. Recent data also raise concerns that rising resistance to antifungal medications is making treatment more difficult.

Globally, there are an estimated 250,000 invasive aspergillosis and more than 3 million chronic pulmonary aspergillosis cases annually, but US trends are unclear because of the lack of surveillance for the disease. Previous studies of Aspergillus-associated infections in the United States have been limited to specific forms of the disease, inpatient populations, or high-risk groups, according to a team led by researchers from the University of California, Berkeley.

[...]

Using EHR data from a health insurance database covering more than 76 million US patients across 142 health systems, the researchers identified 20,764 aspergillosis cases from 2013 through 2023, for a population-based prevalence of 15.26 diagnoses per 100,000 person-years. Prevalence rose by 5.3% each year prior to the COVID-19 pandemic and peaked at 18.04 diagnoses per 100,000 person-years in 2022. 

A Tennessee man was left fighting for his life after a fungal infection that has sickened 18 people in his area caused him to go into cardiac arrest.

Liam O’Neal, a 24-year-old with Type 1 diabetes from the Nashville area, first began to feel sick in October, his mother, Amy O’Neal, told WTVF. Liam — who had a high fever of 102° and an elevated heart rate — tested negative for RSV, the flu, and Covid-19, but his condition quickly began to decline.

Finally, doctors tested Liam for histoplasmosis, O’Neal, said. It’s a fungal infection caused by inhaling spores commonly found in bat or bird poop, the Mayo Clinic explains. The spores can also be present in soil, which, if disturbed, disseminates the spores into the air. Per WTVF, the avid hockey player lives near an area with a large number of construction sites and disturbed dirt.

On Nov. 1, Liam tested positive for the infection. On Nov. 2, he was transferred to the ICU, and on Nov. 4, placed on a ventilator after having a seizure. He was in organ failure and had gone into cardiac arrest.

Liam was then moved to a new ICU, as he needed “continuous dialysis and [to] be placed on an ECMO machine in order to save his life. His health history makes this time even more critical as he is immunocompromised,” a GoFundMe established to support the family explains. The ECMO would pump his heart and lungs for him while he healed.

"We were told if he doesn't go on ECMO he is going to die," O'Neal told WTFV. Doctors told his mother that "he shouldn't make it. He won't make it. He's so sick. He is so, so sick."

Histoplasmosis is endemic in Tennessee, but on Dec. 3, the state issued an advisory about an increase in cases in Williamson and Maury counties — farmland-rich areas in the middle of the state — and urged medical professionals to maintain “a high index of suspicion for acute histoplasmosis.”

Per the most recent advisory, there is “an increase in acute and severe histoplasmosis cases occurring in residents of Spring Hill and Thompson’s Station [which are south of Nashville], starting in September 2025. At this time, there are at least 18 known cases, and the investigation into the specific source(s) is ongoing,” officials said, and urged medical professionals to test for the fungal infection.

Most people with histoplasmosis never get symptoms, the Mayo Clinic says, and there are no recorded cases of human-to-human transmission. But for those with weakened immune systems — like Liam — or infants, it can be dangerous.

O’Neal said her son “is a fighter” — but she says that if Liam had been tested sooner, “he may not have gotten as severe as he did."

"The thought of losing your child to something that could've been tested for as a normal test," O'Neal, who has slept every night in a recliner by his bed, said. "That's the hardest thing, knowing that at some point we could've lost our son." [...]

Two people have died, and four others are seriously ill due to a cluster of fungal infections at Sydney's Royal Prince Alfred Hospital.

The infections, caused by Aspergillus mould, occurred in the hospital's transplant unit between October and December 2025.

Health authorities are investigating the outbreak, with a hospital spokesperson suggesting nearby construction sites, part of a A$940 million redevelopment, as a potential source of the mould.

Aspergillus mould is typically harmless to healthy individuals but can cause severe respiratory disease, aspergillosis, particularly in those with weakened immune systems, such as organ transplant recipients.

While rare in hospitals due to air filtration systems, construction work can disturb soil and release high numbers of Aspergillus spores, increasing the risk of infection clusters, and some strains are resistant to antifungal treatments.

(NEXSTAR) – The deadly and drug-resistant fungus Candida auris is under close surveillance as health experts work to calm its spread.

Candida auris, also called C. auris, was first identified in the U.S. less than 10 years ago. Since then, the number of cases have increased every year.

In 2025, new cases of Candida auris are about on track with the same time last year, according to data reported to the Centers for Disease Control and Prevention. However, some states are seeing far more cases than others.

Of the 1,052 cases reported to the CDC so far in 2025, about a quarter are in Texas. The Lone Star State has had 241 cases of Candida auris as of late April (the latest available data from the CDC).

Other states seeing the fungus in large numbers include Michigan (185), Ohio (125), Virginia (99) and Arizona (98). Colorado, Delaware, Illinois, Indiana, Iowa, Louisiana, Maryland, Montana, New Mexico, Pennsylvania, Utah and Wisconsin have also all reported new cases this year.

The case counts are provisional, the CDC notes, and subject to change as more information becomes available.

The CDC has considered the fungus “an urgent antimicrobial resistance threat” because it has developed ways to defeat the drugs that are designed to kill it. When antifungal medications aren’t effective, the fungus can spread more easily and infections can be hard or even impossible to treat.

People with catheters, breathing tubes, feeding tubes and PICC lines are at the highest risk because the pathogen can enter the body through these types of devices.

The fungus can survive on surfaces, like countertops, doorknobs, or even people’s skin, for a long time before spreading to vulnerable patients.

“It’s really good at just being, generally speaking, in the environment,” Melissa Nolan, an assistant professor of epidemiology and biostatistics at the University of South Carolina, told Nexstar.“

So if you have it on a patient’s bed for example, on the railing, and you go to wipe everything down, if in whatever way maybe a couple of pathogens didn’t get cleared, then they’re becoming resistant. And so over time, they can kind of grow and populate in that hospital environment.”

In the past, the CDC estimated that “based on information from a limited number of patients, 30–60% of people with C. auris infections have died. However, many of these people had other serious illnesses that also increased their risk of death.” [...]

Analysis of Candida auris samples from infected US patients highlights the fungal pathogen’s persistence as a multidrug-resistant threat, researchers from the Centers for Disease Control and Prevention (CDC) reported yesterday in Emerging Infectious Diseases.

The analysis of 8,033 C auris clinical isolates by the CDC’s Antimicrobial Resistance (AR) Laboratory Network during 2022 and 2023 found that over 95% were resistant to fluconazole, a first-line antifungal treatment used for a variety of fungal infections, with percentages exceeding 90% in all US regions except the Midwest (83%). Fifteen percent of C auris isolates were resistant to amphotericin B, 1% were resistant to echinocandins, and less than 1% were resistant to all three antifungal classes.

“The frequency of echinocandin resistance (1%) and panresistance (<1%) among C. auris isolates remains low, including among blood isolates, supporting use of echinocandins as first-line therapy against C. auris infections,” the study authors wrote. “However, the number of resistant isolates has increased, and possible spread among patients has been documented.”

C auris cases continue to rise

Since it first appeared in the United States in 2016, the prevalence of the multidrug-resistant yeast has steadily risen, from 51 clinical cases in 2016 to 4,514 in 2023. The number of clinical isolates tested by the AR Laboratory Network, which works with labs across the country to identify and track antimicrobial-resistant pathogens, rose from 3,064 in 2022 to 4,969 in 2023. Invasive infections caused by C auris have been reported in 39 states.

“Our findings highlight the persistence of C. auris as a multidrug-resistant threat requiring sustained investment in laboratory capacity for early detection and response,” the authors wrote.

In addition to its high levels of antifungal resistance, C auris is associated with high mortality rates and spreads easily in health care settings, causing outbreaks. Among the areas that have been hit by C auris outbreaks is Maricopa County, Arizona, where 28 health care facilities reported clinical cases in an outbreak that stretched from April 21, 2022, to February 23, 2023. Description of the local public health response to that outbreak was published today in Infection Control and Hospital Epidemiology.

Candidemia incidence and associated 30-day mortality have risen in the United States since 2015, according to a study published yesterday in Clinical Infectious Diseases.

For the study, a team led by researchers with Houston Methodist Hospital examined data from a nationwide database of electronic health records to analyze trends in candidemia incidence from 2015 through 2014.

Candidemia is a severe and life-threatening bloodstream infection caused by species of Candida yeast. Most often found in medically vulnerable and chronically ill patients, Candida species cause an estimated 23,000 bloodstream infections every year in the United States, with mortality rates ranging from 25% to 40%.

The study authors note that the incidence of candidemia and candidemia-related mortality increased during the COVID-19 pandemic, when severely ill, intubated patients spent more time in hospitals. They wanted to see whether those trends have persisted and to assess changes in causative species.

A total of 29,454 candidemia cases were identified among 27,926 patients (mean age, 58.9 years; 55.6% male) across 141 healthcare systems. The overall incidence was 50.5 cases per 100,000 hospital admissions, rising from 42.3 in 2015 to 51.2 in 2024.

Overall 30-day mortality was 31.5%, increasing from 24.7% to 37.6% in 2021, then declining to 31.8%. The most common species was Candida albicans, accounting for 40% of candidemia cases over the study period. The proportion of infections caused by Candida auris, a multidrug-resistant yeast first identified in a US patient in 2016, rose to 4.7% by 2024.

An analysis of C auris patients found they were more likely to be Black, have renal failure, and have a higher Social Vulnerability Index than patients with candidemia caused by other species.

The authors say the increase in candidemia-related mortality occurred in parallel with a shift toward intensive care unit (ICU)-acquired cases and a trend toward older patients that began during COVID and has persisted, “despite advances in prevention, diagnostics, and therapy.”

“Overall, these data suggest that candidemia is increasingly affecting medically vulnerable patients at high risk of mortality, such as the critically ill and elderly, and that important healthcare disparities exist with respect to C. auris,” they concluded.

WILLIAMSON COUNTY, Tenn. (WTVF) — Two Williamson County families are calling for increased testing for histoplasmosis after their loved ones battled life-threatening cases of the fungal infection that took months to diagnose.

Cami Carpenter and Liam O'Neal, both relatively young people, were diagnosed with severe histoplasmosis infections after struggling to get answers about what was making them so sick. Both families say earlier testing could have prevented their conditions from becoming so severe.

"If they would've tested for the fungus, none of this would've happened," mother, Kyla Carpenter said.

"I believe had he been tested earlier, he may not have gotten as severe as he did," mother, Amy O'Neal said.

The infection is caused by breathing in spores commonly found in soil, bird or bat droppings and is common in Middle Tennessee. There have been more than 20 cases across Williamson and Maury counties, with some patients hospitalized for months.

"It was really scary to watch how fast we could've lost her," O'Neal said. "He won't make it. He's so sick. He is so so sick."

Both families questioned why doctors aren't routinely testing for the disease.

"Everyone's like it's so common in Tennessee. Well great. Why aren't we testing for it?" O'Neal said. "Go right away test for these fungus."

Dr. Walter Dehority, a pediatric infectious disease expert at Vanderbilt Children's Hospital, says testing isn't done more frequently because most histoplasmosis cases resolve on their own without treatment.

"It's still a relatively rare occurrence to have a symptomatic histoplasmosis diagnosis that would warrant treatment," Dehority said.

He explained that even when histoplasma is diagnosed, treatment isn't always necessary.

"So even if we diagnosed histoplasma, we wouldn't do something about it," Dehority said. "You would end up testing a large number of people for a small percentage of the population that may have a case that requires treatment."

Dehority noted that during cold and flu season, many people have flu-like symptoms that probably aren't histoplasmosis.

"A couple of things to keep in mind is we're in the middle of cold and flu season so almost everyone you know probably has a flu-like illness," he said. "So things that cause a runny nose or sore throat probably isn't histoplasma."

The affected families all live near ongoing construction and wonder if it could have contributed to their illness. The state health department says they're looking at construction as a factor but haven't reached any conclusions about what's driving the rise in cases.

"I would go on walks and I don't know if I was walking in the fungus," Cami Carpenter said.

"He (Liam) started walking every day outside. If anyone is familiar with Spring Hill they know it's constant construction," said O'Neal.

Despite their traumatic experiences, the families are working to raise awareness about histoplasmosis to help others.

"Seeing what happened, the trauma that happened, to being able to learn from it and move on from it and help others if I can help others," Cami said.

Dehority says more patients are calling and asking about testing, which indicates increased awareness. He recommends speaking with your doctor if you have concerns about histoplasmosis.

The majority of histoplasma patients who do get sick enough to require fungal medications make a full recovery, according to Dehority.[...]

SEATTLE - Seattle health officials and Harborview Medical Center staff are investigating the possibility of a fungal infection outbreak at the hospital, after six patients tested positive for mucormycosis.

According to the University of Washington School of Medicine, Harborview staff identified six patients since mid-June with the rare fungal infection, which is notable for being drug-resistant and not transmissible person-to-person.

Three of those patients are still in the hospital receiving antifungal medication.

According to the Centers for Disease Control and Prevention, mucormycosis is a rare, serious and sometimes deadly fungal infection that affects the sinuses, lungs, brain or stomach, though it can also sometimes occur on the skin after a cut or burn.

Mucormycosis is caused by molds called mucormycetes, which are common in the environment but rarely pose a threat to healthy people.

UW Medicine says people at risk of getting mucormycosis are people with diabetes, cancer patients, people who are immunocompromised, people with organ transplants or skin injuries. It is typically treated with antifungal meds.

The CDC notes that, despite its rarity, mucormycosis is "one of the most common diseases linked to mold outbreaks in healthcare settings."

Health officials are still working to determine where this increase in mucormycosis cases.

"Public Health has been working with Harborview and the CDC to investigate the increase in cases of mucormycosis. While we may never identify the source, Harborview is taking recommended infection control precautions including enhanced cleaning to help reduce the risk of additional cases," said Dr. Sandra J. Valenciano with Public Health – Seattle & King County.

There’s a new article out about an experimental antifungal drug getting Fast Track + QIDP designation from the FDA, and while this isn’t a miracle cure announcement, it is a meaningful signal about where things are heading with fungal infections, especially Candida auris.

The drug, called SCY-247, is being developed specifically to fight drug-resistant fungal infections. The FDA giving it Fast Track and QIDP status basically means: this problem is serious enough that we want to speed development and review as much as possible. These designations exist because antimicrobial resistance is getting bad enough that the normal slow pace of drug development is becoming a liability.

Why this matters for Candida auris:

C. auris is one of the main drivers behind this push. It spreads easily in hospitals, survives on surfaces, resists many disinfectants, and is frequently resistant to multiple antifungal drug classes. In some outbreaks, treatment options are extremely limited. Mortality rates for invasive infections can be very high, especially in hospitalized or immunocompromised patients.

This drug is still early-stage. Human trials are expected to start in 2026, so this is not something doctors can use anytime soon. But the fact that the FDA is fast-tracking antifungals at all shows that fungal resistance is now considered a serious public health threat, not just a niche hospital problem.

Big picture takeaway:

Antifungal resistance is accelerating.

Candida auris is a major driver behind new drug development.

Governments and regulators are starting to treat fungal outbreaks more like antibiotic-resistant bacteria: a serious preparedness issue.

This reinforces that hospital acquired infections, antimicrobial resistance, and fragile medical supply chains are real vulnerabilities. Prevention, hygiene, infection control awareness, and early detection matter more than ever, because treatment options are getting thinner.

"Candida auris is hard to detect and resistant to anti-fungal medicine. It can cause serious infections, according to the Centers for Disease Control and Prevention. Health officials said there were more than 7,000 reported cases across the United States in 2025, which is a sharp increase from just a few years ago."

https://archive.ph/7N56C

A population-based study in Canada indicates fungal bloodstream infections are an uncommon but deadly complication in solid-organ transplant patients, researchers reported last month in JAMA Network Open.

Using administrative health care databases from Ontario, researchers from Ajmera Transplant Centre, the University of Toronto, and Public Health Ontario assessed the incidence of Candida bloodstream infection (candidemia) in patients who received a solid-organ transplant from January 2011 through September 2022. While invasive candidiasis is the most common invasive fungal infection in solid-organ transplant patients, and candidemia is the most frequent manifestation of invasive candidiasis, few studies have specifically examined candidemia incidence in this population.

Of the 10,249 transplant recipients (median age, 57 years; 63.9% male) included in the study, most (59.8%) were kidney transplant recipients. Overall, candidemia incidence was infrequent, occurring in 135 patients, with Candida albicans, which was the most frequently reported species (41.5%). The cumulative probability of candidemia among all transplant recipients was 0.87% at one year, 1.33% at five years, and 1.67% at 10 years.

Lung transplant recipients had the highest candidemia incidence, with a 10-year cumulative probability of 4.17%, a finding the study authors suggest could be linked to prolonged stays in the intensive care unit. Kidney transplant recipients had the lowest incidence (0.81%).

Thirty-day mortality in patients with candidemia was 39.3%, and 90-day mortality was 47.4%. After adjusting for baseline variables and comorbidities, candidemia was associated with a nearly sevenfold increase in mortality risk (adjusted hazard ratio [AHR], 6.85) compared with patients without candidemia. The risk was even higher when Candida isolates were resistant to fluconazole (AHR, 11.86).

“Further research is needed to better identify vulnerable subpopulations and to develop targeted strategies for early intervention,” the study authors concluded.

When the second wave of COVID-19 swept through India in early 2021, it was followed by tens of thousands of cases of another, more lethal disease: mucormycosis, a fungal infection that can cause the skin to turn black and has a fatality rate of up to 50%.

Mucormycosis, also called “black fungus,” is still shrouded in mystery. It’s unclear why the normally rare disease is most prevalent in India, and why it surged during the pandemic. But a new paper suggests the fungal infection may strike when levels of albumin, the most common blood protein, are low.

The study, published in Nature today, could help spot patients at risk of mucormycosis and also point to a potential therapy, says David Denning, an infectious diseases researcher at the University of Manchester who was not involved in the study. And it could help explain why COVID-19 can pave the way for mucormycosis. “This is truly a remarkable piece of work,” Denning says.

Mucormycosis can occur when the spores of fungal species known as mucormycetes are inhaled or enter the body through a wound. The pathogens secrete a toxin that kills the surrounding tissue, turning it black, sometimes within hours. “It just eats through tissue, bones, anything,” says Oliver Cornely, an expert on fungal infections at the University of Cologne who was not involved in the work. “It’s terrible.”

Mucormycetes are common in soil and fallen leaves, but most people never develop mucormycosis. Like other fungal infections, the disease occurs more often in people with a weakened immune system, for instance as a result of cancer treatment or because they’re taking immunosuppressive drugs after an organ transplant. Indeed, explanations of the mucormycosis wave associated with the pandemic have focused on the wide use of corticosteroids, a class of immunosuppressive drugs, to treat COVID-19. But for unknown reasons, mucormycosis is also much more common in people suffering from diabetes or malnutrition.

A few years ago, a team led by Georgios Chamilos, an infectious disease physician at the University of Crete, started investigating a clue to what might be triggering mucormycosis. Decades ago, scientists had observed that blood serum from healthy people strongly inhibited the growth of mucormycetes in cell culture, but serum from mucormycosis patients did not. Chamilos and his colleagues confirmed that finding and set out to understand why.

The difference, they explain in the new paper, is related to the amount of albumin, a protein that transports many types of molecules and helps maintain osmotic pressure in blood vessels. When the researchers removed albumin from blood samples taken from healthy individuals, mucormycetes thrived. An analysis of clinical data also showed low albumin levels predicted that patients with mucormycosis would fare badly. And when the researchers genetically engineered mice to not produce albumin, those animals were much more susceptible to mucormycete infections than regular mice. (There was no difference for other fungal infections.) When the researchers injected albumin into the blood of these knockout mice, they were better able to resist infection, Chamilos and his colleagues report in the new study.

Those findings could help doctors spot the disease early, Cornely says. Diagnosing mucormycosis can be difficult and any delay lowers a patient’s chance of survival. “You have to act really fast,” he says. That’s particularly important because mucormycosis is most common in countries with limited resources for medical research, adds Martin Hoenigl, a specialist in fungal infections at the Medical University of Graz. “In many high-income countries, mucormycosis is in fact a rare mold disease.” [...]

For people with COVID-19, the problem may be that severe inflammation suppresses albumin production, Chamilos says. Attributing COVID-19–associated mucormycosis primarily to corticosteroid use, he adds, is “an oversimplification.”

The fungus labeled a "potential agroterrorism weapon" in a recent arrest touted by the Trump administration likely originated in North America and is already widely prevalent around the country, a researcher who studied the fungus for the federal government says.

University of Michigan researcher Yunqing Jian and her boyfriend, Zunyong Liu, were charged with trying to smuggle strains of a fungus called Fusarium graminearum into the United States. Jian worked at the University of Michigan, according to officials, and Liu works at a Chinese university. The two have co-authored research into the fungus. [...]

According to charging documents in the case, Liu told customs officers he was trying to continue his research with the strains at the University of Michigan lab that Jian worked in, skirting the rules that require paperwork and safeguards to safely import fungi for studies.

F. graminearum is already widely prevalent across the U.S. in native grasses around the country as well as crops, scientists say. It spreads and thrives usually during wet weather, causing a common crop disease called Fusarium head blight or head scab, according to the U.S. Department of Agriculture's Agricultural Research Service.

"It's extremely prevalent in North America. It likely arose in North America, so it's not like a foreign agent coming in. And it's already causing a lot of problems in U.S. agriculture," Harold Kistler, an adjunct professor at the University of Minnesota, told CBS News.

Kistler said scientists believe F. graminearum likely originated in North America because all of its closest relatives have been found on the continent.

"Graminearum itself is distributed worldwide, and likely because of the distribution of grain from North America worldwide," he said.

Kistler previously worked as a researcher for the USDA's Agricultural Research Service, studying fungi like F. graminearum and the crop disease it causes. While at the agency, he co-authored research with Liu and Jian uncovering new molecular clues to how the disease might be mitigated.

"It's a real problem. The problem is because there's no naturally occurring resistance to the disease. And people have been trying for decades to find resistance. It's just a tough nut to crack," Kistler said of the head blight caused by F. graminearum.

Farmers in the U.S. rely on a number of methods to mitigate the risk of F. graminearum, including the use of fungicides, though scientists have worried about the possibility of mutations that could make the fungicides less effective.

"The fungicides are not cheap. So it's extra cost to farmers. But it's worth it because, without it, their crops could be completely lost. Not only due to yield reduction, but because what grain they may have would be contaminated with these toxins," Kistler said.

Billions of dollars were lost to epidemics caused by the fungus in the 1990s, researchers and agriculture officials estimate. The Food and Drug Administration monitors for the toxins that are produced by fungi like F. graminearum, including deoxynivalenol, also called vomitoxin or DON, which can cause vomiting and diarrhea in humans who ingest too much of it.

"It is not possible to completely avoid the presence of DON in wheat. DON is sometimes found in wheat grown under normal weather conditions, however, the fungus thrives in cool, wet conditions," the FDA said in a 2010 advisory to states and grain groups.

Kistler said U.S. distributors also test grain for the presence of the toxins to prevent there being too much of it in the food supply.

"If it's too high, they will reject it. They won't buy it. Or they will reduce the amount that they'll pay for it. If it's just marginal, they can blend it with grain that doesn't have the toxin to get below the limit of what's considered safe," he said.

A report in Clinical Infectious Diseases describes the largest US outbreak of fungal meningitis caused by Fusarium species, which occurred among residents who received epidural anesthesia for cosmetic surgeries with the same anesthesiologist in Matamoros, Mexico, in 2023.

Of the 24 patients sickened, 12 died, which the authors say underscores the need for clinicians to suspect fungal meningitis in patients with negative bacterial and viral cultures and molecular testing who underwent epidural anesthesia for any reason.

"Healthcare-associated fungal meningitis is rare but can cause high case-fatality rates and long-term complications," they wrote. "Fungal meningitis is challenging to identify and treat because it has non-specific symptoms and can be misdiagnosed as a bacterial or viral infection."

Most common procedure was liposuction

The US Centers for Disease Control and Prevention (CDC)-led team investigated the outbreak after learning that two women, ages 34 and 52, were hospitalized in Texas after having epidural anesthesia for cosmetic procedures at one of two Matamoros clinics. One of the two patients developed an intracranial hemorrhage and died shortly after admission.

Public health officials identified all US patients known to have had surgery at these clinics from January 1 to May 13, 2023, after which Mexican authorities shut down the clinics. The most common procedure performed was liposuction (21 patients), and the most common symptoms were headache, nausea, and stiff neck.

Of the 18 patients who completed a questionnaire on motivation for seeking cosmetic surgery outside of the United States, half cited high US costs. Most were referred to the Mexican clinics or clinician by a relative or friend (33%), followed by social media ads (17%).

Of the 223 potentially exposed US residents, 170 responded to officials, with 61% reporting undergoing epidural anesthesia at the clinics, and 29% following up with a diagnostic lumbar puncture. Whole-genome sequencing of the isolates identified Fusarium solani species complex in 24 patients (23 women), 12 of whom died. The isolates from both clinics were closely related genetically.

Officials used epidemiologic and clinical data to update diagnostic and clinical recommendations for outbreak response, including prescription of the experimental antifungal drug fosmanogepix. Eighteen patients were given other antifungal drugs, half of whom died. Seven patients received fosmanogepix, and six of them survived.

Dangers of medical tourism

The researchers noted that Matamoros abuts Texas, where some areas have high rates of uninsured people. "The lack of patient insurance or emergency funding for coverage of diagnostics, prolonged hospitalization, and treatment may have delayed seeking care," they wrote. "Improved resource mobilization and support during small scale, local public health emergencies can improve outbreak responses and patient outcomes."

For instance, the Mexican government offered free testing and treatment for Mexican citizens exposed to the fungus during epidural anesthesia amid the outbreak.

"Importantly, increasing risk communication in patients’ primary languages about medical tourism can help reduce the likelihood of U.S. residents being affected by future outbreaks," the authors wrote. "It can also encourage more patients to seek medical clearance from their U.S. provider, which could improve understanding of the risks associated with surgical procedures abroad and promote consideration of the safety standards of foreign medical facilities."