Fungal Infection Appears Common Among Urban Kids

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Fungal Infection Appears Common Among Urban Kids

http://my.webmd.com/content/article/32/1728_79425.htm

By Salynn Boyles

WebMD Medical News Archive Reviewed By Dr. Tonja Wynn Hampton

May 10, 2001 -- Most city dwellers have strong opinions about

pigeons. Some see them as harmless, flying urban friends, while to

others they are the equivalent of rats with wings.

But are they a hazard to human health?

Breathing air contaminated with pigeon droppings is believed to be

responsible for the most common central nervous system disease among

patients with AIDS. Now a study from New York suggests the fungal

infection responsible for the disease is common among healthy

children living in urban areas.

After conducting a special blood test, researchers from the Albert

Einstein College of Medicine found that 70% of tested children over

the age of 5 had been infected with the fungus Cryptococcus

neoformans, and over half of those as young as age 2 had been

infected. It is not yet clear whether people who do not live in

cities have the same level of exposure, they say, or if healthy

people whose immune systems are not compromised -- as is the case

with AIDS patients -- develop infection-related illnesses.

" We were very surprised to find that cryptococcal exposure was so

high in these children, " study author L. Goldman, MD, tells

WebMD. " At least in urban areas like the Bronx, exposure appears to

occur very early in life, and it is probably associated with signs

and symptoms we haven't identified yet. " Goldman is an associate

professor of pediatrics at Albert Einstein College of Medicine.

If the fungal infection does cause illness among otherwise healthy

people, it is likely that the symptoms are being blamed on something

else, Goldman says.

" Children with this infection, for example, could possibly develop

flu-like symptoms that a doctor might assume to be a virus, " he

says. " Again, we don't know yet what symptoms are associated with

this infection, or if there are any symptoms associated with it.

Those studies have not been done. "

Fungal specialist Guadalupe Reyes, PhD, of Cleveland's Case Western

Reserve University Center for Medical Mycology, says it is possible

that fungus-related infections do cause unrecognized illnesses among

children and adults with healthy immune systems. She says failure to

recognize fungal infection is a common and serious problem among

patients whose immune systems are compromised.

" This infection is very easy to diagnose, but doctors often don't

think about fungi, " she says. " Patients are given antibiotics, which

obviously don't work, because they have a fungal infection, [not a

bacterial infection]. "

In the study, published in the May issue of the journal Pediatrics,

blood samples from 185 children from the Bronx who ranged in age from

1 week to 21 years were evaluated for C. neoformans infection. Few

children under the age of 2 had been infected, but 56% of those

between the ages of 2 and 5 carried the infection. Antibodies for the

infection were found to persist throughout childhood, suggesting that

reinfection might be common.

" We don't know the long-term consequences of infection, but it is

clear form our findings that many children are being exposed, making

the infection a potential cause of common childhood disease, " Goldman

says. " Our goal now is to learn what occurs in instances of acute

infection and to identify ways to combat it. "

The findings could have implications for those trying to develop a

vaccine designed to prevent infection with C. neoformans. It has been

suggested that such a vaccine could prevent the life-threatening

diseases associated with infection in AIDS patients and others with

compromised immune systems.

" If, as our study indicates, most people are already infected at a

very early age, then a vaccine approach to preventing infection

probably won't work, " Goldman says.