Fungus led to 8 deaths

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Fungus led to 8 deaths

Parksville Qualicum News - BC, Canada*

By FRED DAVIES

News Reporter

Oct 12 2007

http://www.pqbnews.com/portals-code/list.cgi?

paper=50 & cat=23 & id=1082041 & more=0

If you haven't heard of Cryptococcus gattii you're not alone.

Researchers are struggling to discover why the fungus isn't

attracting more attention — particularly on the east side of

Vancouver Island where isolates of C. gattii are most prevalent.

Since first identified in Rathtrevor Park in 1999, C. gattii

infection has risen, then stabilized, but Vancouver Island's

incident rate is among the highest in the world at 27.9

cases/million. Roughly 27 cases of infection were reported annually

between 2002 and 2006 and the pathogen is attributable to at least

eight deaths.

" I'm sure people in your communities have lost cats and dogs to

this, " said Dr. Anne-Marie Nicol, a University of B.C. research

associate specializing in risk communication. " The media coverage

has been particularly low in comparison to West Nile ... from an

epidemiological point of view you would expect more and more but no;

news coverage is skewed the other way with West Nile receiving up to

five times the amount. "

This, Nicol noted, despite the fact West Nile has not yet been

discovered in B.C.

" It's very curious. The last person that died was a young man. "

A new surveillance survey released by the BC Centre for Disease

Control reveals that by the end of last year six cases of C. gattii

infection were confirmed on the Lower Mainland with no connection to

Vancouver Island. The centre is alerting doctors to be on the

lookout for symptoms similar to those for pneumonia-including fever,

prolonged cough and weight loss-that could be the result of

Cryptococcus.

Dr Bartlett, an assistant professor at UBC's School of

Environmental Health said global warming can't be ruled out as

reason for the fungi's emergence locally.

" It's only ever been described in semi-tropical parts of the world, "

said Bartlett. " It's been able to establish an ecological niche. For

it to do be able to do so there was a change that favoured it at a

microscopic level. "

The surveillance summary Bartlett said, " is the first time a lot of

information has been assessed for the public to have easy access. "

The largest number of C. gattii infection is in the 70 to 79 year

age group, with patient ages ranging from two to 92 years. Smoking

is linked to the potential for infection with 45 per cent of

patients being current smokers at the time of diagnosis. Pre-

existing lung conditions and steroid use are also risk factors for

infection by the airborne pathogen.

In Rathtevor Park Thursday and Pat Heggie of said they

visit the park despite the threat of infection.

" This is where it first started as I understand, " said . " We

come up here once a year. I don't know if we've just been lucky. "

The Heggies are perhaps an exception to the rule, demonstrating

clear knowledge of the C. gattii threat.

" I've heard it has a long incubation and doesn't show up until

later, " said .

Dr. Bartlett said early detection and treatment is essential,

allowing for generally successful treatment with an anti-fungal

agent.

The incubation rate for C. gattii infection can be as much as

several months but it is not passed from person to person or from

infected animals. The fungus has been linked to deaths of dogs, cats

and porpoises.

" Once it goes into the meningitis form it is much more difficult to

treat, " said Bartlett.

C. gattii has been isolated from tree surfaces, soil, air and water

and is most common in the Coastal Fir and Western Hemlock

forests along the east coast of the Island. The highest incidence

rate reported is among residents of Qualicum Beach with 15 cases. No

activities or exposures have been identified that increase the risk

of infection.

Nicol said it's important the media be involved in a more proactive

way to assist the public in identifying the risk and in knowing when

to seek medical assistance.

She said one hypothesis of why C. gattii hasn't garnered more

attention is that " there isn't any management strategies for it. You

can't just slap on DEET and you'll be fine. "

Fungus concern

PAT HEGGIE AND husband of said they visit Rathtrevor

Park annually despite knowledge of the park as epicenter to

occurrence of Cryptococcus gattii infection.

reporter@...