In June of 2017, the Florida Department of Health requested that health care providers and laboratories start reporting a mysterious fungus infection.
The scary fungus wasn’t even categorized as a reportable disease in Florida.
But it’s called Candida auris, or C. auris, and it can kill you fast.
The problem: The public in Florida doesn’t seem to know much about it.
C. auris is a yeast that is resistant to multiple drugs. It causes serious bloodstream and other infections – particularly in patients who already have medical problems and are in hospitals, nursing homes and other facilities.
“More than 1 in 3 patients die within a month of C. auris infection,” according to the CDC.
I am not trying to frighten Floridians, but Floridians should know as much as possible about this fungus.
The CDC considers C. auris a “serious global health threat.”
As of Sept. 30, the CDC states that “multiple cases of C. auris have been reported from Australia, Bangladesh, Canada, China, Colombia, France, Germany, India, Israel, Japan, Kenya, Kuwait, Malaysia, Oman, Pakistan, Panama, Russia, Saudi Arabia, Singapore, South Africa, South Korea, Spain, the United Kingdom, the United States (primarily from the New York City area, New Jersey, and the Chicago area) and Venezuela.”
Just last week, the New York Post wrote this story with the headline: “Potentially fatal ‘superbug’ Candida auris spreading in New Jersey.”
The story went on to say that C. auris fatalities are estimated at 162,000 worldwide.
In the United States, the CDC has reported at least 806 confirmed clinical cases of C. auris infections, and 30 probable cases. The data doesn’t show how many of those cases led to deaths. And the numbers are likely to be higher when cases are updated.
Another 1,642 patients have been found to be colonized with C. auris, which means they’re found to be carrying C. auris on their bodies, but they’re not sick with the infection.
Of 13 states and Washington D.C., Florida has the fourth highest numbers of cases of C. auris in the United States — 24 clinical cases — followed by New York, Illinois and New Jersey, according to the CDC.
Four different strains of C. auris have emerged around the world, including in the United States, “likely introduced through international travel,” according to a 2019 report on antibiotic resistance.
Florida is involved in all four of the strains: The South American strain— Florida, Illinois, Massachusetts; the African strain— California, Florida, Indiana; the South Asian strain — California, Connecticut, Florida, Maryland, New York, New Jersey, Oklahoma, and the East Asian strain— Florida, New York.
The New York Times has written extensively about C. auris, given that New York has the highest numbers of cases – at least 388 confirmed infections and another 4, probable.
Last month, the newspaper reported that New York is the first state to identify medical facilities where C. auris patients have been treated.
Here’s what the New York Times wrote:
“New York became the first state to release the names of the medical facilities that have treated patients with Candida auris, a fungus that is resistant to major medicines and has been spreading globally under a cloak of secrecy.
C. auris is one of the newer and more mysterious examples of such infections. The New York Times has spent the past year documenting its rise as multiple governments declined to identify or confirm the names of hospitals and nursing homes with the presence of C. auris. Some hospitals, including major academic institutions, declined to discuss cases even when family members or physicians confirmed them.
New York health officials said they decided to break with that practice and disclose the names of the institutions with cases in the state over the past three years because of how rapidly C. auris has spread. Their aim, they said, was to provide transparency to consumers and encourage hospitals and nursing homes to help stop its spread.”
Moving on to Florida:
I asked the Florida Department of Health (FDOH) what was going on with this scary fungus infection.
Officials at the department initially provided this response in writing:
“In Florida Candida auris is not a reportable disease. However, the Department has requested notification of Candida auris infections as it a disease of public health concern.
Since 2017 the Department has identified 24 clinical cases and 54 colonizations for a total of 68 confirmed cases.
FDOH is responding to the spread of C. auris by implementing a CDC containment strategy. Collaborating with county health departments and facilities, FDOH provides ongoing technical assistance for conducting surveillance, works with laboratories to ensure the use of proper C. auris detection methods, and provides guidance to facilities for hand hygiene, environmental cleaning, and contact precaution strategies.”
When I asked about additional questions, the department provided some additional information:
As to why C. auris is not a reportable disease, the department said:
Outbreaks of Candida auris infections are reportable. The Council of State and Territorial Epidemiologists and CDC agreed on a case definition for Candida auris in 2018. We are in the process of updating our reportable disease rule (last updated in 2016) to include C. auris.
The department also revealed that the C. auris cases (both clinical and colonizations) have been rising, from two people in 2017, to four in 2018, and 62 in 2019. The agency did not provide information on the number of deaths, if any, in that data.
The department provided information about Florida counties with C. auris cases, including Miami-Dade, Broward, Duval and Alachua counties, with the majority in Broward and Miami-Dade.
I asked if the department would identify specific facilities where C. auris cases have occurred, such as nursing homes.
The answer? “All patient information reported by providers and laboratories is confidential.”
And, “The Department does not release facility level information for C. auris investigations.”
That means it doesn’t look like Florida will be as transparent as New York in identifying where C. auris is occurring in Florida facilities.
So for grandmas, grandpas, moms, dads and other loved ones in nursing homes, hospitals and other facilities, please be as vigilant as possible about this scary fungus infection.
It’s called Candida auris, or C. auris, and it can kill you fast.