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From Victoria Times-Colonist

Fungus takes hold on Island
Cryptococcus gattii linked to at least four deaths, but scientist says attack rate low

CanWest News Service
Tuesday, November 23, 2004

A tropical fungus that has taken hold in temperate British Columbia is more infectious and deadly on Vancouver Island than anywhere else on Earth, a study has found.
But illness caused by the fungus, Cryptococcus gattii, remains rare.
"There is no need to panic," said Sarah Kidd, a University of B.C. researcher who worked on the study. Her team didn't even feel the need to wear masks when collecting samples from infected trees and soils, she said.
Cryptococcus gattii has infected 101 people who live on or visited eastern Vancouver Island and killed at least four people, as well as a horse, 11 porpoises that washed ashore and dozens of cats and dogs.
It is 37 times more infectious on Vancouver Island than it is in Australia, where it has long been a fixture in the environment, an international research team reported Monday in the Proceedings of the National Academy of Sciences.
Symptoms of infection include cough, lethargy and night sweats. In serious cases, cryptococcus moves from the lungs into the central nervous system.
People who are already ill face a higher risk of problems from the fungus. Antifungal medications are available but must be taken for several months, said Kidd, adding that most infections are now caught early and successfully treated because physicians and veterinarians have cryptococcus on their "index of suspicion."
The researchers say the infection rate may drop as islanders develop immunity to the fungus over time. They also say there's no need to avoid Vancouver Island or to wear protective masks when walking in the woods.
While Cryptococcus gattii has proved more infectious on Vancouver Island, the researchers stress it isn't as lethal or fast-spreading as many other pathogens. "The attack rate is still quite low," said Bartlett.
Vancouver Island has an infection rate of 37 a year for every million people, compared to about one case a year for every million people in Australia. There is less risk of infection in the winter months, perhaps because B.C.'s rains wash the cryptococcus particles out of the air.
Older men are most vulnerable to infection, perhaps because they tend to spend a lot of time outdoors, said Laura MacDougall, an epidemiologist at the B.C. Centre for Disease Control.
Vancouver Island's outbreak, which began in 1999 and continues today, highlights the need for global monitoring of the fungus, say the scientists, who suspect it may be expanding its range because of climate change.
The outbreak was initially linked to Rathtrevor Beach Provincial Park near Parksville, but cryptococcus has now been found in soil and on trees from Victoria north to Courtenay.
The scientists warn the fungus now has the potential to cause infections in temperate regions around the world.
"From a scientific point of view it is extraordinary," said Karen Bartlett, a co-author of the report who studies environment health at the University of B.C. "It is so rare to be right on top of an emerging infectious disease."
The fungi can be deadly when drawn deep into the lungs. The cells have a "slippery" sugar coating that enables them to evade the lungs' protective cells, which normally engulf and kill infectious organisms, said Bartlett. Being a tropical fungus, cryptococcus also has the ability to thrive at the body's temperature of 37 C, which kills most other fungi.
How and why the tropical fungus took hold on the Island is still a mystery, but researchers believe it is there to stay.
"I don't think it's going to go away anytime soon," said Kidd. She moved from Australia to B.C. to study the outbreak of the fungus. It lives in soil and under tree bark, and can also survive in seawater, which could help explain the porpoise deaths.
Bartlett suspects Cryptococcus gattii may have been on Vancouver Island at low levels for a long period, but no one noticed because it was incapable of becoming airborne and infecting people or animals.
She said something changed in the late 1990s. The leading theory is that the eastern coast of Vancouver Island has become warmer and drier, making the region more hospitable. Or perhaps, the researchers say, logging and urban development opened up a new niche for the fungus. It may have been imported on a plant from the tropics.
© Times Colonist (Victoria) 2004


Victoria Times-Colonist
November 24, 2004

Correction
A quote about antifungal medication being available to successfully treat cryptococcus infections should have been attributed to Laura MacDougall, an epidemiologist at the B.C. Centre for Disease Control. Because of an editing error, the information was attributed to the wrong person in a story written by Margaret Munro in Tuesday's Times Colonist.