Fungal infections in particular are "kind of a neglected area," says Kadosh. "About 30 different classes of antibiotics are available, but only five major classes of antifungals." As is often the case, it sometimes takes an outbreak like the C. gattii episode--the more mysterious and deadly the better—to catch our attention. Indeed, soon after the outbreak at Rathtrevor Park, the British Columbia Centre for Disease Control sent letters to all physicians in British Columbia to alert them to the presence of the fungus on Vancouver Island. Unfortunately, as Bartlett points out, that didn't help Merriman. Nor does it help someone like me, a visitor to the island who then goes home to Chicago and might develop a cough 6 months later.
All of which points out a dilemma: There's this scary . . . thing . . . out there randomly spitting spores, a thing that has the power to kill you if your doctor doesn't know to look for it as a cause of mysterious flulike symptoms. You probably won't become infected with it, but then again, no one can say for sure you won't. But hey, don't lose sleep over it, and by all means keep tromping through those Pacific Northwest fungi forests and reserving campsites.
One thing that is clear is that C. gattii has spread from Vancouver Island to mainland British Columbia to the United States. The mystery is how. And why now? C. gattii had previously been found only in Australia, among eucalyptus trees. Was the fungus somehow brought here? If it was, why has it taken hold only in the Northwest?
There are no definite answers, but Bartlett has theories. She doubts, for instance, that the fungus was imported, because the C. gattii strain found in the Pacific Northwest differs from strains found in other parts of the world. Instead, she believes, the fungus had probably been dormant on Vancouver Island all along, perhaps for thousands of years, and had been kept in check by other organisms.
So what happened? "In this case, we think that what's been changing is the climate," she says. "Over the past 40 years, the average temperature in British Columbia has increased. Average snow cover in winter has decreased. Drought frequency has increased. That tiny climate shift was probably enough to suddenly give C. gattii an advantage over other microorganisms that it previously had been in dynamic balance with." Translation: Thanks to global warming, C. gattii suddenly became the bully on the block. Combine that with the rain-soaked environment of the Pacific Northwest, Bartlett says, and you have the ideal makings for a fungi fairyland.
As it turns out, C. gattii's predilection for the soggy and boggy is good news when it comes to its potential for showing up in other parts of the United States, says Harris. "Fungi are very particular about climatic conditions, and it's unlikely that we'll see C. gattii spreading to areas with drastically different climates than those found in the Pacific Northwest and California." Certain parts of the United States are similar enough to the current outbreak zone that the fungi could potentially flourish, but it's hard to predict where and when that could occur. "More likely, we will see cases among travelers to the Pacific Northwest and California," Harris says.
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