Bartlett traveled to Rathtrevor with her research team, made up primarily of her students, and began collecting soil samples and swabbing trees. "By the end of that summer, we had mapped C. gattii colonies all the way down to Victoria," she recalls. To date, more than 250 C. gattii infections have been reported in British Columbia. The mortality rate: about 9 percent. By contrast, the 2009 H1N1 "swine flu" virus had a mortality rate under 1 percent. Bartlett suspects that even more unreported cases may have been out there, perhaps from people who just assumed they'd been sick with something else. "There is no question that mild or asymptomatic cases are present but not counted," she says. "A few of the cases were diagnosed simply because the person was having a chest x-ray done, and a cryptococcus nodule was discovered."
Since 2004, 70 people have been infected with C. gattii in the United States, according to Julie Harris, Ph.D., M.P.H., a staff epidemiologist with the U.S. Centers for Disease Control and Prevention. Sixteen have died. "We are still seeing increasing numbers of cases in the United States each year."
Fortunately, unlike many bacterial and viral infections, a bout with C. gattii doesn't mean its victim is contagious. Another consolation is that only a tiny fraction of those exposed to C. gattii become sick, and when they do, the infection is treatable with antifungal medications. But this assumes that the physician actually knows what to treat. Until recently, doctors in the Pacific Northwest were routinely misdiagnosing the illness as flu, pneumonia, or even lung cancer. "They would see these lung nodules and make the diagnosis," Bartlett says. "In one of the first cases, a doctor told a patient, 'I've got good news and bad news for you: The good news is you don't have cancer; the bad news is you have AIDS.'"
Because the topic of fungi garners scant attention beyond a relatively small circle of mycologists, awareness has been slow in coming. "It's appalling how little time is spent in medical school training students to diagnose fungal infections," says Kadosh.
"People are dying out there from fungal infections because doctors don't know how to diagnose them."
Bartlett agrees. "One of the big challenges for us was to convince physicians to say, 'Hey, there's a new organism on the block that's going to be affecting people with apparently healthy immune systems,'" she says. "'It's going to look like lung cancer, but it isn't.' "
For all the wondrous—and destructive—things fungi can do, they seem to lack the crucial ability to attract researchers. "Even though fungi are the most fascinating critters in the world, there aren't that many scientists who think so," says Mueller. "The number of people studying the great diversity of species, and the great diversity of questions, is just downright small."
One reason is the competition. Yes, fungi are higher on the evolutionary ladder than, say, bacteria and viruses. And as C. gattii has shown, they are just as effective at causing disease and death. But bacteria and viruses still hog the scientific spotlight—and research dollars.
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