Infectious fungi (yes, fungi)

Over the past month, you’ve probably seen the headlines about Ebola and hantavirus. And for good reason. These viruses hold pandemic potential. But this isn’t a ‘the world is falling apart’ story about these viruses. This is a very short story about infectious fungi for your… entertainment… edification…mental health?

OK fine, probably not the last one.

In any case, there has been little media attention to the emerging epidemic of TMVII, the emerging fungal infection now identified in at least 10 states in the US and in several countries throughout the globe. I do appreciate Them interviewing me about it, though. I’m also giving a webinar this Thursday about TMVII for the New England Public Health Training Center. You can register here. It’s free — this is not a money grab.

I was also recently invited to participate in a debate for the Triangle Center for Evolutionary Medicine (TriCEM). The premise was that each of the folks in the debate had to choose a pathogen type which we believed was the greatest risk to humanity in the context of climate change. (Insert joke here about how climate change is still a debate to some too, but I digress).

In any case, I of course accepted the invitation. When picking topics, someone chose vectorborne diseases (think ticks and mosquitoes), someone did waterborne (cholera), another on zoonotic infections which had pandemic potential (which I think was a little loaded to begin with), and then the last of us… fungi.

Also, yes, that was a pop culture reference about the famous TV show/ video game where fungi in essence turn people into zombies. Which, to be fair, has been becoming a pretty popular trope in recent science fiction! Anyone else read or seen “Girl with all the gifts”?

Back to the story — the premise of the debate was simple. The audience had a pre-debate vote about which pathogen type (vectorborne, waterborne, zoonotic, or fungal) they thought was the greatest threat. Then, each of us gave our opening statements. Afterwards, we were to have an actual intellectual fighting match. (OK, it wasn’t that serious, nothing like a UFC match happening on the White House lawn……).

After the preliminary vote, I was in dead last. People just didn’t think fungi were that big of a threat. But in the end, I wound up changing the most opinions of the folks in the room and “won” the debate. If I had hair, I’d do a hair flip. Since I don’t… what can I say, I’m just a fun guy.

Bad jokes aside, I think there’s actually something important here and I plan to turn our conversation into a scientific paper. But for now, I’ll drop two of my favorite quotes that I think helped me win, and for you to sleep on (I promise I’m not trying to cause nightmares):

Unlike many pathogens that move through humans, animals, or vectors, fungi are deeply integrated into environmental systems themselves. Fungal spores can travel hundreds, and even thousands, of miles through the air. You cannot close borders to spores moving through planetary atmospheric airstreams.

This one I think is poignant because today you may be reading about how travel restrictions and quarantines are being figured out in response to Ebola. How would we do that for an environmental fungi? This second quote is also pretty powerful:

We eat fungi. But fungi also evolved to consume us after death. That ecological role is precisely why fungal adaptability deserves serious attention.

Over the coming months, I’ll be heading into to several countries from East Asia to South America to better understand and promote pandemic preparedness. From the emerging fungi I’ve hinted at today to new variants of flu, and everything in between, there’s a lot we have to have to do in public health to help protect, well, the public.

We are entering a brave new world for infectious diseases in a changing climate. I hope to share meaningful stories, adventures, and learnings from the (unfortunately) many things to come.

Please share with anyone who you think would enjoy this, and as always, feel free to ask any questions.

Tom Carpino, PhD, MPH

Hock Infectious Disease Fellow

Climate and Sustainability Fellow

Duke Global Health Institute

PS — Medium wants me to drop in a photo to this article, so here’s a not-so-graphic photo of someone with a TMVII infection, courtesy of the Minnesota Department of Health… and later reshared by Duke.