AUSTIN, Texas — Four years after the coronavirus pandemic ravaged the world, a bicameral, bipartisan group of lawmakers introduced a plan to ensure the United States would not be caught off-guard and rendered helpless at the mercy of a contagious disease.
But health experts who track fungi and spoke at the SXSW Conference on Monday evening lamented how Congress has failed the public for 3 1/2 years by refusing to pass a bill that would give the U.S. an advantage in preparing for the growing likelihood of a fungal disease pandemic.
The Pioneering Antimicrobial Subscriptions to End Upsurging Resistance, or PASTEUR, Act was introduced by Sens. Michael Bennet (D-CO) and Todd Young (R-IN) alongside Reps. Scott Peters (D-CA), Drew Ferguson (R-GA), Mike Levin (D-CA), and Jake LaTurner (R-KS) in September 2020 and reintroduced twice.
Democrats and Republicans have failed to get it across the finish line, leaving health officials with serious concerns about America’s preparedness for a health disaster that would pale in comparison to the coronavirus for a slew of reasons.
Climate change and warming global temperatures have forced fungi to evolve and, with that, spread into locations they have never before been found, increasing the risk to the public, the experts told attendees at a panel discussion.
“Fungi are inextricably linked to the environment. They live out there,” said Dr. Tom Chiller, chief of the Mycotic Diseases Branch of the Centers for Disease Control and Prevention, during the discussion. “So when the environment changes, when climate change causes these environmental changes and fungi have to adapt, they’re going to compete, they’re going to try to be the best, they’re going to try to tolerate higher temperatures.”
“Why are fungi emerging simultaneously on multiple continents that are resistant and tolerate higher temperatures? I mean, it’s something to do with the environment and climate change,” Chiller said.
Scientists are aware of roughly 4 million species of fungi. Only a few hundred can exist in humans because certain species have evolved to withstand warm body temperatures, unlike the millions of other types of fungi.
“Fungi can’t survive at high temperatures, but they do well in low — with coldblooded animals like the dinosaurs. They couldn’t defend themselves against fungi,” Chiller said. “There’s a lot of potential when you’re talking only a couple hundred out of 4 million, so it makes us concerned about these pathogens emerging and catching us by surprise.”
Brazilian authorities have discovered a type of fungi that can spread from cats to people called sporotrichosis. Chiller said it was one example of how fungi have figured out how to become smarter than the environment they are up against, and it presents serious concerns, given how many millions of nonhuman fungi could evolve into ones that can survive in people.
Another type of fungal infection similar to athlete’s foot has emerged in South Asia and is spreading around the world.
“It no longer just stays on your feet. It comes up your leg, gets [into] your entire torso. You cannot treat it because it’s developed the ability to resist the common drugs we use,” Chiller said. “This is just a skin fungal infection that, again, it’s not going to kill you, but … it’s miserable.”
Dr. Paul Verweij, consultant microbiologist and professor of clinical mycology at the Radboud University Medical Center in the Netherlands, said the problem is that the limited treatments available contain the same antifungal chemicals used to spray crops. Prolonged exposure to these chemicals has started to render some people resistant to treatment.
“We use these fungicides to protect our crops, which is really important for food security. At the same time, we use the same molecule to treat patients,” Verweij said.
The European Union has looked at how to regulate fungi to prevent cross-resistance between antifungal medications and treating crops.
In the U.S., the CDC and Environmental Protection Agency have teamed up on the same task.
One private-sector doctor developing new antifungal agents at a biotech company said Europe is moving faster than the U.S. but that time is of the essence.
“Eighty percent of our crop pathogens are fungi,” said Dr. John Rex, chief medical officer for biotech company F2G. “If we’re going to produce crops, especially in these changing environmental conditions, we’re going to need fungicides.”
Infections in humans can be viral, bacterial, or fungal. The challenge is that a plethora of treatments are available for the first two types, but cures for fungal infections, assuming the patient is not immune to them, are extremely limited.
“There are at least a dozen completely different kinds of treatments for bacterial infections,” Rex said. “For fungi, there are three major classes, only three.”
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Verweij treats people with fungal infections and said not only are they often not considered initially by physicians diagnosing sick patients but that the healthcare industry lacks adequate testing, and existing treatments can wreak havoc on the body.
“Get the PASTEUR Act passed because that’s the process that would allow the U.S. government to pay for the occasional breakthrough antibacterial, antifungal material that actually needs to be bought on a fire-extinguisher basis to ensure that it stays on the market,” Rex said. “That is the No. 1 thing that I want to see happen.”