Most healthy people probably don’t have to worry about a fungus called Candida auris, or simply C. auris. But if your immune system is compromised, it’s a different story.
Health officials say C. auris should be of special concern to people whose immune systems are not at full strength, and I’m one of them. I’m being treated with Lemtrada (alemtuzumab). It, like Ocrevus (ocrelizumab), Mavenclad (cladribine), and aHSCT (autologous hematopoietic stem cell transplantation), weakens our immune systems as part of the treatment process. Steroids such as Solu-Medrol (methylprednisolone) and prednisone, can also reduce immune system activity.
Not only might my immune system not be up to doing battle with this attacker, the healthcare community might not have very many weapons with which to fight it. According to the U.S. Centers for Disease Control and Prevention (CDC), some C. auris infections resist all three of the medications used to treat fungal infections. The fungus is also very persistent, and can remain on a surface for weeks. As reported in The New York Times, it’s extremely difficult to eradicate in a hospital setting.
“Everything was positive — the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,” the president of a New York City hospital where there was a C. auris death told the Times. “The mattress, the bed rails, the canister holes, the window shades, the ceiling, everything in the room was positive.”
The C. auris threat is considered ‘urgent.’
The Times reports, “Over the last five years, (C. auris) has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center (the Royal Brompton Hospital in London) to shut down its intensive care unit, and taken root in India, Pakistan and South Africa.” Recently, it’s been reported in New York, New Jersey, and Illinois.
C. auris is one of only three bacteria and fungi on the CDC list of “urgent threats” — the highest threat category. Dr. Lynn Sosa, the deputy state epidemiologist for Connecticut, sees C. auris as the top threat among drug-resistant infections. She told the Times “it’s pretty much unbeatable and difficult to identify.” Its symptoms — chills and fever — are similar to those of many other infections.
Should you be concerned?
As I wrote at the start of this column, most healthy people probably don’t need to worry about this. That’s also likely true for most of us with MS. The CDC says C. auris is still rare in the United States, where it seems to be confined to healthcare facilities. “[P]eople who have lines and tubes that go into their body (such as breathing tubes, feeding tubes and central venous catheters), seem to be at highest risk,” the agency added.
I’ll be asking my neurologist about about C. auris during my next appointment. I suggest you do the same if you’re being treated with steroids or with a DMT that suppresses your immune system. If you’re treated in a healthcare facility, you might want to ask whether it has had any C. auris cases. There’s probably not much you can do other than being vigilant, but knowledge is power. Just knowing that this nasty fungus is lurking might allow it to be quickly identified and treated if unexplained chills and fever that don’t react to medications should strike you.
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