Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Axios on your phone

Get breaking news and scoops on the go with the Axios app.

Download for free.

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Illustration: Aïda Amer/Axios

Large numbers of COVID-19 hospitalizations and more immunocompromised people in general are fueling a global spread of a different threatening microbe: invasive fungi.

Why it matters: These infections cause more than 1.6 million deaths worldwide every year, and the microorganisms responsible for them are starting to evade the small supply of antifungal drugs.

"Out of all the [hospitalized] people who have gotten bacterial infections, 5% will die from those infections. And that's a lot. ... When it comes to life-threatening fungal infections, 50% of those patients will die from that infection. And that message really isn't being told."
— Ciara Kennedy, former president and CEO, Amplyx Pharmaceuticals

Background: Out of the 6 million species of fungi, some hold a positive benefit for humans, ranging from beer-making yeast to biotech ingredients to our gut microbiome.

  • Some only pose mild harm to humans, such as ringworm, and most cannot thrive in human body temperature.
  • But the newest emerging microbe threat is the growing number of invasive fungi that normally attack a large number of immunosuppressed people, like COVID-19 patients in India, but can sometimes infect healthy people as well.
  • Exact numbers of fungal infections are unknown, as they are "often underdiagnosed or misdiagnosed," says Tom Chiller, chief of the CDC's Mycotic Diseases Branch.

There are only three main classes of drugs to fight invasive fungal infections.

  • It can be difficult to find great treatments, partly because fungi are eukaryotes and similar to humans in how their cells are structured and get food, and "a lot of times something that's toxic to a fungus will also be toxic to humans" and cause liver or kidney damage, Kennedy says.
  • Azoles are the only antifungal that can be administered in pill form, but there's growing resistance to it, partly from "extremely broad" use in agriculture, Kennedy adds.
  • Drug resistance "is a real problem," says Chiller, who's also a physician and an epidemiologist. Over the past 5–10 years, the CDC has seen some worrisome trends in invasive fungi, including Candida auris, Aspergillus, Coccidioides immitis and Coccidioides posadasii (or Valley Fever), and Sporothrix brasiliensis.

What's happening: Invasive fungi — ones that become systemic or breach normal immune barriers — are a growing concern, Chiller says.

  • Some studies have "found that Aspergillosis, which is a rare mold disease, is actually one of the more common things found in autopsy, and yet the death certificates or the reasons for dying do not include it," Chiller says.
  • Drug-resistant C. auris can kill people, and some strains are becoming resistant to all three classes of antifungals. Plus, it often doesn't respond to traditional ammonia cleaners, and contaminated surfaces have caused some nursing homes, long-term care facilities and hospitals to rip out entire units.
  • "And it's really transmissible — more like a bacteria than a fungus. We don't think of candida or candidemia as a contagious disease in a hospital, but now we need to because of this new species Candida auris," Chiller says.
  • John Rex, chief medical officer of a rare fungal disease drug company called F2G, says "the really scary one" is Valley Fever, which is endemic to the Southwest U.S. but is spreading due to climate change. While most people who breathe in the spores are fine, "about 5% have an awful, awful outcome ... and we do not think we have anything that cures it, ever."
  • Sporothrix brasiliensis, a fungus that has taken off in South America, is a concern because it's a zoonotic disease that can spread from cats or rats to humans, Chiller says.
  • Even more worrisome: Both Valley Fever and sporotrichosis can infect healthy humans.

What's next: The FDA recently approved a new class of antifungal drugs for vaginal yeast infections — the first new class of antifungal drugs in 20 years — although it's not for invasive disease, Chiller says. But, he adds he's "excited" there may be new drugs soon that target invasive fungal disease using new mechanisms.

  • Amplyx, which was recently sold to Pfizer, has the drug fosmanogepix in Phase II of clinical trials and targets a protein unique to fungi with the hope it will offer a new, safe and effective antifungal class, Kennedy says.
  • Rex says he's also hopeful the bipartisan bill, the PASTEUR Act, will help bolster the drug pipeline for "new anti-infectives that have a value to society that is so wildly disproportionate to the value the innovator can receive based on sales, because we work so hard to not have the infection."

Go deeper

Updated 35 mins ago - Health

CDC: Vaccinated people in COVID hotspots should resume wearing masks

CDC director Rochelle Walensky and top infectious disease expert Anthony Fauci at a Senate HELP committee hearing. Photo: J. Scott Applewhite-Pool/Getty Images

The Centers for Disease Control and Prevention issued updated guidance on Tuesday recommending that vaccinated people wear masks in indoor, public settings if they are in parts of the U.S. with substantial to high transmission, among other circumstances.

Why it matters: The guidance, a reversal from recommendations made two months ago, comes as the Delta variant continues to drive up case rates across the country. Millions of people in the U.S. — either by choice or who are ineligible — remain unvaccinated and at risk of serious infection.

Olympics medal tracker

Data: International Olympic Committee; Chart: Connor Rothschild/Axios
Bryan Walsh, author of Future
2 hours ago - Politics & Policy

U.S. students fell 4 to 5 months behind during pandemic

An empty classroom in Pinole, Calif. Photo: David Paul Morris/Bloomberg via Getty Images

Elementary school students in the U.S. ended the school year four to five months behind their expected level of academic achievement, according to a new report.

Why it matters: Months of school closures and often inferior remote education eroded what schoolchildren would have learned since the pandemic began, and caused some to go backwards.