Outdated Maps of Disease-Causing Fungi May Lead to Delayed and Missed Diagnoses
Fungi in the soil cause a significant number of serious lung infections in 48 out of 50 states and the District of Columbia, including many areas long thought to be free of deadly environmental fungi. This is according to a recent study by researchers at Washington University School of Medicine in St. Louis.
Studies from the 1950s and 60s indicated that fungal lung infections were a problem only in certain parts of the country. That is no longer the case, shows a new study, which was published on November 11 in the journal Clinical Infectious Diseases. Doctors who rely on outdated maps of disease-causing fungi may miss the signs of a fungal lung infection, resulting in delayed or incorrect diagnoses, the researchers said.
“Fungal infections are much more common than people realize, and they’re spreading.” Andrej Spec, MD
“Every few weeks I get a call from a doctor in the Boston area – a different doctor every time – about a case they can’t solve,” said senior author Andrej Spec, MD, an associate professor of medicine and a specialist in fungal infections. “They always start by saying, ‘We don’t have histo here, but it really kind of looks like histo.’ I say, ‘You guys call me all the time about this. You do have histo.’”
How Soil Fungi Infect People and Spread Disease
Histoplasma, or histo, is one of the three main species of soil fungi that cause lung infections in the U.S. Historically, Histoplasma was found in the Midwest and parts of the East, Coccidioides in the Southwest, and Blastomyces in the Midwest and the South. But a growing number of case reports and anecdotes suggest that all three have expanded out of their traditional ranges in recent decades, most likely due to climate change.
Challenges in Diagnosing Fungal Lung Infections
People develop fungal lung infections after breathing in spores from fungi in the soil. The spores become airborne when the ground is disturbed by farming, landscaping, construction, or even just by people walking around in fungi-rich environments such as caves. Most healthy adults and children can fight off a fungal infection handily, but infants, older adults, and people with compromised immune systems may develop fever, cough, fatigue, and other symptoms. Fungal lung infections easily can be mistaken for bacterial or viral lung infections such as COVID-19, bacterial pneumonia and tuberculosis.
Histoplasmosis is an infection caused by a fungus called Histoplasma. The fungus lives in the environment, especially in soil that contains large amounts of bird or bat droppings. People can get histoplasmosis after breathing in the microscopic fungal spores from the air. Although most people who breathe in the spores don’t get sick, those who do may have a fever, cough, and fatigue. Many people who get histoplasmosis will get better on their own without medication, but in some people, such as those who have compromised immune systems, the infection can become severe.
“People with fungal lung infection often spend weeks trying to get the right diagnosis and appropriate treatment, and the whole time they’re feeling terrible,” said lead author Patrick B. Mazi, MD, a clinical fellow in infectious diseases. “They usually have multiple healthcare visits with multiple opportunities for testing and diagnosis, but the doctor just doesn’t consider a fungal infection until they’ve exhausted all other possibilities.”
Nationwide Mapping of Fungal Infections
Spec, Mazi, and colleagues set out to determine where soil fungi are sickening people today. The Centers for Disease Control and Prevention (CDC) last revised its maps of disease-causing fungi in 1969.
The researchers calculated the number of fungal lung infections nationwide from 2007 to 2016 using Medicare fee-for-service claims from all 50 states and the District of Columbia. Using the patients’ home addresses to identify counties of residence, they calculated the number of cases per 100,000 person-years for each county. (Person-years are a way to correct for the fact that counties can have wildly different population sizes; one person on Medicare for one year is one person-year). Counties with more than 100 cases caused by Histoplasma or Coccidioides, or 50 cases caused by Blastomyces, per 100,000 person-years were defined as having a meaningful number of fungal lung infections.
Alarming Spread of Soil Fungi Across the U.S.
Of the 3,143 counties in the U.S., 1,806 had meaningful numbers of lung infections caused by Histoplasma, 339 of Coccidioides and 547 of Blastomyces. These counties were distributed across the majority of the U.S. Across the 50 states plus DC, 94% had at least one county with a problem with Histoplasma lung infections, 69% with Coccidioides and 78% with Blastomyces.
“Fungal infections are much more common than people realize, and they’re spreading,” Spec said. “The scientific community has underinvested in studying and developing treatments for fungal infections. I think that’s beginning to change, but slowly. It’s important for the medical community to realize these fungi are essentially everywhere these days and that we need to take them seriously and include them in considering diagnoses.”
Reference: “The Geographic Distribution of Dimorphic Mycoses in the United States for the Modern Era” by Patrick B Mazi, MD, John M Sahrmann, MA, Margaret A Olsen, PhD, Ariella Coler-Reilly, BA, Adriana M Rauseo, MD, Matthew Pullen, MD, Julio C Zuniga-Moya, MD, William G Powderly, MD and Andrej Spec, MD, 11 November 2022, Clinical Infectious Diseases.
DOI: 10.1093/cid/ciac882
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67 Comments
I’ve been telling my husband for a few years that this is a much bigger problem than people realize and will become far worse and that we’ll be seeing it mentioned more bc it won’t be able to be ignored for too much longer. It’s not only climate change, any upset of the natural biome sets up the circumstances for pathogenic fungi to take advantage. We will be seeing fungal pathogens affecting plants and animals as well, I’m already seeing it in my local area since 2019. We have disrupted the natural environment on a massive scale.
What is the test needed to see if you have these disease?
“… most likely due to climate change.”
Without citing any study specifically intended to establish cause, they opine that the apparent increased range is “most likely” a result of climate change. There seems to be an uncritical mind set that because the climate has warmed, any changes in the environment MUST be a result of “climate change.” Correlation does NOT prove causation! This could be a spurious correlation resulting from better data collection and improved diagnoses.
My husband is from eastern Virginia and he had blastomycosis back in the early 80s he was 16. Coon dogs died one boy lost a lung and all were very very sick.
Or can it be that it should be made illegal to use fertilizers in an air born (u know like spreading pig feces in the irrigation system) and polluting the water systems.
Well, as these are considered soil fungi, it’s much more likely that they’re spread by plowing and disking (disturbing the soil) during a breezy or windy day. I’d be for banning plowing and disking long before I’d get behind banning the spreading of organic fertilizers.
banning the spreading of organic fertilizers? What would that do? Ban compost to while your at it.
This is probably from the carona virus shots but I’m sure they will deny it
Very funny, but read the report – all data was taken before 2017, before the Corona virus was in the US.
And you probably should stop blaming anything, including plants and fungi, for your personal fear of going to the doctor.
Climate change would make the ranges change northward. Instead, they are spreading randomly as would be caused by lots of dust being moved from one location to another–planes, trains, and automobiles. Or, it could be better detection.
Also, the US population has more than doubled since 1955, meaning that there are more people living in areas that were formerly ‘free’ of fungal diseases. With low population densities, there may not be enough people to trigger a concern if a small percentage catch a lung disease. In the frontier days, tuberculosis was called “consumption,” and doctors probably couldn’t tell TB, emphysema, chronic pneumonia, or silicosis from a fungal lung infection. I, and about 75% of my barracks at Fort Bliss (TX), had severe upper respiratory infections in 1968, which didn’t respond to penicillin. Neither the army doctors or my civilian family doctor thought to treat us for fungal infections, despite “Valley Fever” being known in California since before the Gold Rush days. The maps clearly reveal that the spatial resolution of infections was poor in the 1950s.
The unexamined assumption that the rate per capita of fungal infections was low in the 1950s may be wrong.
I had histoplasmosis in 2009. It took doctors 3 months to diagnose it. They thought I had lung cancer and I came close to a loboscopy. Two radiologists sent me into a CT machine to position a needle biopsy. They were able to get a sample from a nodule in the bottom of my lungs. I took itraconizole for several.months to get rid of it. Doctors speculated that the fungus came from Canada goose sh** from an adjacent farm being plowed or bat/bird s*** from one of my 9 fireplaces in my 200 year old house. Interestingly, histoplasmosis was featured on an episode of House, MD. Go figure.
This is great humor. Thank You for the laughs.
Correction – lobectomy not loboscopy.
Lobectomy not loboscopy. Please correct my previous comment
I like how the maps show how like human activity is probably transferring it from place to place but they just can’t help themselves and once again blame it on climate change. Looks like a emerald ash borer map where once it gets into an area it spreads out.
Great info. I bet my Mom has this. Thanks
Took the test back in 2017 and they said it was COPD. Two years later i thought i had covid but with testing i found out i had histoplasmosis. I have rattling when i breathe. I hope this not a life threatening disease.
The CDC has a very informative information page about the fungus. The original surveys performed in the 1940s to sample the geographic distribution of the fungus used reaction skin tests of lifelong residents. I find that to be a very ingenious and definitive way to make that particular determination, necessitated by a dearth of the kind of advanced diagnostic and testing technology we have in the modern era. Modern society doesn’t give previous generations enough credit for a lot of really great work they did and the challenges they confronted. The CDC page also has a likelihood map of presence of the fungus, which seems to challenge the climate change causation. The fungus is most likely to be present in some of the coldest places like the Dakota’s and Minnesota. But the fungus does prefer moisture and climate warming does put more moisture into the atmosphere, so the increased moisture more so than temperature probably has a lot to do with it. Another factor that may influence the incidence of disease is that modern society is a lot more sanitized than it used to be, depriving people of the opportunity to develop lasting immunity when they’re young and strong. There’s something to be said for getting out there and playing in the dirt when you’re younger.
https://www.cdc.gov/fungal/diseases/histoplasmosis/maps.html
Climate change denial is a way worse infection, not preparing for what’s about to happen HELLO they didn’t tell you to wear a mask for the past 3 years for fake COVID it’s because they know what’s coming FIRES AND DISEASE AND FLOODS…..
I agree that Valley Fever in California has allowed knowledgeable testing, even in pets (dogs). I was given an anti-viral in 1993 after relocating to Desert Hot Springs. But in 2007 was put on antifungals + finally improved but still disabled. Have had “brain fog” for years. Being misdx’d impacted my life as my family closed ranks labelling me a malingerer. I am alone at 73 & severely depressed. Thank you for this news.
This article,should be required reading for all dog owners especially in upper NW Wisconsin,anywhere neR the Namekogan River.Look up.articles on Girl Scouts who were on a camping trip near Merrill,they got Blasto..from digging to put tent stakes in..There are factual accounts of severe and fatal Blasto infections for last 10 years..so.e ended up in Mayo Clinic ,and died anyway!!
I own property in Bayfield Co.,between Son Springs and Drummond area…I had taken my 4 beautiful poodles up in Fall for a week of rest and quiet..walks in the woods,searches along the shoreline…little did I know how deadly this trip would be…my dogs,all 4 got Blasto..and after a first misdiagnosis I insisted on Bronchial lavage,on each..the Blasto hyphae were so thick,and dogs were put on Ampho..B..but it was not soon enough..After $5000.treatment on each dog..They all had to be put to sleep.
Blasto is a killer!!!but whats even worse is the fact it is not as recognizable as” a dangerous fungal infection,”that can be fatal to humans and their beloved dogs!!!
And,it is spreading due to the manner of transmission that fungus uses…spores float through the environment..in the air,in water,rotting leaves,soiling on your shoe/boot soles!!!Its insidious and so dangerous!!There needs to be much more education on these 3 fungal diseases..public health and medical agencies have dropped the ball on it,and should issue infectious i
area maps so precautions can be taken. Sign me,Diana,a broken hearted dog owner.
Please spread this fungal infection issue.
Hello good day to all we appreciate all this article was very interested to know more details should we make sure very important to change way of our life from made Mena to nature because in this time we have many items in the market very affects our health and human development many different types of products to district Destroying nature, and this is what kills us, and it is man-made, especially the arms industry. The world must agree to stop all industries that harm nature, humans, and animals. They are the chemical industries.
We are currently in the age of globalization in which no caution is taken when making decisions issued by the heads of major countries Which is always looking for special interests and there is no interest in other countries that suffer from poverty, diseases, ignorance and lack of provision of infrastructure, especially education and health services For this reason, there is no balance in order to correct the error, but rather there is competition for supremacy in the manufacture of weapons that are man-made and kill humans, animals and plants with the pollution of the environment, especially nuclear weapons.Nuclear and war exist in multiple places I wonder why there is no choice of peace, safety and a clean environment
Why are there industries that are harmful to health, safety and the environment? Why choose the manufacturing industries of petroleum and its derivatives? Why are we looking for the cost to be within intense competition and exploiting poor countries for cheap wages, especially children working in very difficult conditions? Where are the human rights that we call for? Why were not all industries of good quality and long-lasting so that we can get out of global warming, disasters and controversial events, which are automatically formed due to air pollution and the presence of chronic diseases?
If the misconceptions persist, the worst is sure to come
Because we believe
With human and animal rights and a clean environment, we hope that the peoples of the earth will turn to peace, safety and a clean environment
We speak in order to launch the process of reform and sustainable development in the world and for all of us as human beings to live in peace and all international disputes will end within the activities of discussion and frank and serious dialogue aimed at building human capacities and developing and implementing joint projects between countries in general. Thus, we are honest, speaking and respecting human rights
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Just get on all natural antifungals….caprylic acid, olive leaf extract, grape seed extract, curcumin, and if able to and be careful in using oregano oil. Go to an all natural food store speak to an herbist ! Antibiotics do not work most are fungal born redundant! All of the above are antifungal & antiinflammatory.
I had a mass removed from my left lung after inconclusive biopsy. Every doc was sure it was lung cancer from 40 yrs of smoking.Turns out it was an old calcified fungal infection.🙌🙌🙌
Leaf blowers must be contributing to the airborne spread as well.
We destroy the earth. What do we expect? My mother had to have lung surgery due to a fungal infection. I have noticed it is so much more difficult to grow vegetables here in my area due to fungus and other pests. It’ll all get much worse. There are no golden years left for Earth.
If people had ANY idea what leaf blowers spread, they’d stop using them immediately.
Histoplasmosis is not only a lung disease. My father lost most of his vision due to histo plasma scarring the retina in his eyes in the middle 1960s. If family information and memory serve me right, they sent him to the University of Chicago where he was given cortisone shots. He never regained his vision and was forced to take disability retirement from his work at the Alcoa aluminum plant and lafayette, indiana.
They had necrotizing black fungus in the air with C0VID in India, killed facial and lung tissue
9 fireplaces?? You live in a castle? I dont have 9 rooms in my house. Its a 3 bedroom home. Idk why this article even came up on my phone other than i live in st louis where we are in a heavily red area and my lungs are hurting bad today from my kids bringing home nice germs from school. I love Dr House tho by far my favorite show i have ever watched.
A lot of people are not aware that anti fungal medication, is based on the same chemistry as fungicides for farming. Meaning; If fungus species become more resistent for fungicides by farmers, they also will work less for fungus infected humans. Us!
It would have been a lot smarter if the Pharmacy had made a split for human anti fungal medication and fungicides for farming&crop protetion.
Yes, it would have costed more money, a lot more. But in the end a way better decission, morally, ethically and from a pragmatic perspective.
This way we have created a time bomb.
A small example google all about this topic yourself, *Azoles are antifungal agents used in both agriculture and medicine.*
The spread of the various fungi can be contributed to and I am not the smartest on this platform, population growth, plants and soil transferring because of freight or just plain plants being taken by individuals from and to every place across the country.Not climate change.
If people had any idea how much garbage, dust, and airborne particulate matter that can result in infections, can result from leaf blowers they would immediately cease their use. How common is it for people to leave use leaf blowers around apartments where people won’t pick up their dog feces? And we wonder why people get so sick.
You more or less said it’s caused by birds poop So every year you have bird migration have the snow geese that fly over As you have farmers Who are pumping the pawns dry and they have to fly different places to find water And when they fly over and unfortunately they poop on everyone’s cars vehicles truck semi strand that travels along tooMake migrated farther along And help it spread Because in the fifties and sixties we didn’t have as many cars semis And vehicles traveling to many places or all of the buildings that is built up over there migration area They used to land now they poop over it as a flyover and we just covered and seen it So it dries up faster and blows in the wind
My uncle died 10 years ago of a Blasto infection in Grand Marais, MN (right up by Canada). It took two months to diagnose, and by then it had spread so virulently that he was not able to recover. We had never heard of Blastomycosis before he was finally diagnosed, and killed by it. This threat they speak of is real. He is undoubtedly part of the reason for that heavy northern MN Blasto shading in the map.
Try not to blame Everything on Climate change!!
My father died of histoplasmosis in 2006. He was being treated for rheumatoid arthritis so his immune system was not able to fight it off! I had no idea that he could die of it. That was a shocking thing to happen because I wasn’t in that mindset at all!
I’ve been sick with chronic sinus problems and shortness of breathe for almost 3 yrs now.
A dozen doc visits, a dozen scripts for “antibiotics”, with no change. I’ve tried telling the several docs it’s not bacterial or viral. I believe it’s fungal! They won’t listen!! Last week I find out that I now have leisions on my left lung. And have had for 2 x-rays prior to this 3rd xray. All 3 over a 6 to 8 months time period. Which i was not informed of on the 1st 2 sets. All labs keep showing an infection present. My doc is saying now it’s COPD.
How do I convince a doc to just test for fungal? My home does have mold issues and is always damp or wet underneath. I’ve been “TRYING” for about 2 to 3 years to get out of here to a better place to live. Every path that i see a light at the end of tunnelI has been a train.
But back to question….can someone hopefully tell me how to get a doc to even test for fungal infections?
My husband in 1966 at 23 had Histoplasmosis. We had lived for 2 years in AZ so doctors were baffled but 2 years before we were visiting in Ohio and he spent an afternoon on my uncle’s farm and exploring an old barn. He lost 2/3’s of one lung. Today they would probably use fungal medication not surgery.
Poultry farmers and those people who worked around birds were those who developed histo. The old maps indicate that along the Mississippi River valley and in eastern Texas and Arkansas where poultry farming was large industry. I have Presumed ocular histoplasmosis due to evidence the disease settled in my eye. I worked around government buildings with a large pigeon population for decades, presumably this is where my infection came from. With the rise of people raising chickens in their backyards a potenial rise in children and families having histo is spreading.
People are just realizing thay Fungi will make them or turn them to soil? Fungi has been there longer then us. The problem is us and not the fungi. Eat healthy.
The effect of toxic carcinogenic pesticides, toxic fertilizers causing waterway runoff on a massive scale is another cause to acknowledge.
For years, I have heard in the medical world that many or most people that live in the Ohio Valley show the signs of histo on their chest xray without actually becoming ill. It was usually blamed on pigeon droppings, as we have many of those birds in Ohio. My brother has ocular histo that was explained as having been from cleaning our house gutters as a kid in Columbus.
Source is bird droppings. Bird populations have come back since the banning of DDT.
My husband got blastomycosis in 09 and we were told it was a very fast growing cancer u til they removed part of his lung. It came back a week later from cdc thst it was blasto. We were told that about 63 people a year get it in North America and it was a disease that use to be more common in the 1800s. He spent 2 years on anti fungal meds and it be pretty much destroyed our lives. We live in the country in south east Ohio where there is a lot of farming done. For as rare as we were told it was our neighbor 5 houses down got it almost 5 years later and spent 3 months in the hospital on IV drugs. The house special was on blastomycosis because my husband had recently come home from the hospital and we watched it. It took A long time for them to really figure it out. It is not a common thing or it was not in 09.
What about the popular use of purchasing garden soil?
Don’t believe these companies test for such issues.
Can’t even purchase good potting soil any more.
Tell me WHY. Why are the maps so out dated. Why DONT most doctors question if its fungal? CDC dont they research there? This makes no dang sense.
It’s sue to the use of pesticides and herbicides. Roundup to be more specific. It’s doing damage to the microbes in the soil
So did the study saying anything about wearing masks and did the spores not spread as widely during the covid lockdown now The masks are off again
It is what they spray up in the air by jets. Those jets spray chemicals that we all inhale. They is for global warming they say but it is winter and cold. You see them anytime of the day. It is killing people. The world is not safe anymore.
This map overlay matches exactly where glyphosate is most heavily used.
My husband works with dogs food. It is a highly contagious breeding ground for mold spores. He comes home and brings the mold spores with him. Every night I’m choking . Despite the mold problem in the basement. I’m hats a problem . And climate change and sudden changes of temperatures from cold to hot to rain non stop. Is a perfect breeding ground for mold to be everywhere. Soon we will all be wearing suits, and respirators.
Climate fundamentalists always looking to cast doubt. Try understanding that your much loved fossil fuels industries have known the truth of their products effects on climate and both buried it and spread misinformation about climate change and the scientists. Pretty much reprehensible as the tobacco industry doing the same. But even knowing the truth you folks would still tell the lies because you’re just so bought into “socialism.”
Blaming the spread on Climate Change alone may be ignoring a very VERY important vector (which could / should be receiving much more attention / regulation / monitoring) … and that is soil and plants / agriculture products MOVEMENT
It’s the jets that are over that is pollutant the ground and it’s making people sick.
I was diagnosed 2 years ago with an extremely rare side effect Histoplasmosis causes called Fibrosing Mediastinitus. It creates scar tissue that spreads throughout your mediastinum that can attach to your heart, fill your lungs and into your veins. It’s pretty much like pouring molten plastic into your body and having it harden like cement on anything it attaches to. It has no treatment and no cure… It’s TERRIBLE. I sincerely hope this new found information will help spread awareness of Histoplasmosis and lead to fewer misdiagnosis.
I was diagnosed with Valley Fever October 2020 by Dr. Spec and his team from Washington University Physicians. I had traveled to Arizona for the first time ever and was extremely ill. I had never been so sick and it took me to the local ER. Living in a small town in the Midwest, a fungal infection was not considered…but everything else they knew of was considered. I spent eleven days in Barnes Jewish and had a diagnosis within eight days. Treatment was started immediately thereafter. I have traveled back to Arizona to visit family and am shocked at the number of people unfamiliar with VF. Several have undiagnosed “illnesses” that have never been tested for cocci. That being said, as a patient with this disease, I am very pleased that attention is now being given to “fungal infections” no matter the reasons. Thank you to Dr. Spec and Dr. Mazi and others for their research, care and help with these “fungal infections” that can affect some people for the rest of their lives…simply because they took a breath. I know, I am one of them.
I’m far from a medical professional or one of the “brains” in the world. It seems obvious to me that people are responsible for the spread. So much land that has been undisturbed for 100s of years has been turned into neighborhoods, shopping malls, warehouses, etc..dump trucks and heavy equipment move mountains of soil while digging down to place water and sewer lines or to simply level the area, they then haul this dirt to a temporary dumping spot then haul it again often many miles to another construction site that needs fill dirt. Human population, greed, and total disregard for the earth has once again upset the natural order of nature and once again this planet will purge its self as it has done countless times to previous human infestations that once lived on this planet. Nature is God, not humans.
Blaming “climate change” is a lazy cop-out that brushes aside any real consideration of the most likely causes. Chief of which are modern agricultural processes(which was brushed over in a careless fashion), and the use of avian “fertilizers” in fields. Furthermore, the over use of nitrogen fertilizers is likely supercharging the problem as well. Blaming “climate change” for problems is leading to problems our decendants will have to spend a century cleaning up, because we did not want to really consider environmental impacts beyond five years from today.
I was diagnosed in 2007 and it had almost killed me. I underwent 2 open heart surgeries and still dealing with the aftermath of it. I was td it was rare and know of personally 3 other people that had gotten diagnosed since myself. Relax with all your conspiracy theories. The more we destroy the environment with deforestation and urbanization thing will just get worse and mother nature will retaliate.
I have had what I believe to be a fungal infection for approx. 3 yrs., maybe longer.. Sores pop up all over my body. Been the round of Dr’s. & they believe its physiological. My psychiatrist said “No Way.” I don’t know where else to turn. We have little black dots all over our house.Every where U look. I wish I knew wat to tell the Dr’s. So they would believe me!!
Yeah, leaf blowers ftw… best thing spores could ask for to increase spread.
Histoplasmosis. I hadn’t seen that word since I was growing up in central Illinois. I was a faculty brat growing up around the U. of Illinois experimental farms south of town. Since I was usually alone exploring around the farms it took some real scientific thinking on the part of the doctors to make the connection between the chickens and the faculty brat. The time frame was around 1950. Your map for that time frame and central Illinois shows it exactly.