The Top 5 Infectious Disease News Stories Week of January 18-25

Fungal Infections: Invisible Until It’s Too Late

Fungal infections impact over 1 billion people globally each year, leading to millions of life-threatening cases and deaths. In response to this under-recognized health threat, the Global Action Fund for Fungal Infections (GAFFI) launched the "95-95 by 2025" initiative, aiming to diagnose and treat 95% of serious fungal infections by 2025. Led by David W. Denning, a professor at the University of Manchester, GAFFI addresses the challenges of diagnosing and treating fungal diseases, particularly in regions with limited resources, such as Sub-Saharan Africa and parts of Asia. Denning highlighted significant barriers, including diagnostic gaps and delays in drug approvals. However, progress is being made, with successful projects in Guatemala that improved diagnostic accuracy, reduced misdiagnoses, and lowered mortality rates. Denning hopes to replicate these results globally to improve fungal disease diagnosis and treatment.

The Importance of Local Health Departments in Combating HAIs and AMR

Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials (NACCHO), highlighted the critical role of local health departments in combating healthcare-associated infections (HAIs) and antimicrobial resistance (AR). She emphasized the importance of strengthening infection prevention and control practices, improving surveillance, and advocating for adequate resources at the local level. Freeman noted that the COVID-19 pandemic underscored the need for local health departments in disease surveillance, antibiotic stewardship, and community engagement. She called for greater federal support to ensure these departments can effectively address infections and AR, particularly in rural and smaller communities, where unique challenges exist. Freeman also stressed the importance of coordinated efforts between local, state, and federal entities to combat these health threats.

How Prepared Are We For Avian Influenza?

As the world prepares for potential outbreaks or pandemics, public health measures such as stockpiling vaccines, developing emergency plans, and conducting surveillance are crucial. The federal government, through agencies like the CDC and BARDA, is working to ensure preparedness by developing candidate vaccine viruses (CVVs) for avian influenza (H5) and maintaining a stockpile of vaccines and antiviral treatments, such as oseltamivir. The government is also investing in mRNA vaccine technologies, with Moderna receiving $590 million to accelerate pandemic influenza vaccine development. Lessons learned from the COVID-19 pandemic have highlighted the importance of continuous monitoring and biosecurity measures, particularly for poultry and cattle operations. However, challenges remain, as funding from the pandemic response has dwindled, leaving gaps in resources for future preparedness.

Rezafungin is Noninferior to Caspofungin For All-Cause Mortality in Treating Candida Infections

Candida infections, particularly candidemia and invasive candidiasis, can cause serious complications, including bloodstream infections and organ damage. Diagnosis often takes several days, and despite advancements in PCR testing, the associated mortality rate remains high. A promising treatment for these infections is rezafungin (Rezzayo), a long-acting echinocandin approved by the FDA in 2023. Developed by Cidara Therapeutics and marketed by Melinta Therapeutics, rezafungin was shown in phase 3 trials to be non-inferior to the current standard of care, caspofungin, with a once-weekly dosing regimen that leads to faster treatment response. This new antifungal could offer significant benefits, particularly in ICU patients, by improving recovery times and reducing mortality.

Executive Function Impairments in Long COVID Linked to Brain Changes

A recent review in Cell Reports reveals that Long COVID significantly impairs executive function (EF), including skills like shifting, inhibition, and working memory, which severely impact daily activities. The review, based on 31 studies, found that these cognitive difficulties are linked to brain alterations in regions such as the orbitofrontal cortex and cerebellum. Neuroimaging studies showed structural and functional changes, including reduced gray matter and hypermetabolism, suggesting that neuroinflammation caused by COVID-19 affects these crucial cognitive areas. The impairments contribute to heightened stress, anxiety, and depression, creating a cycle that hinders recovery. Although some cognitive improvements are observed over time, early identification and intervention are essential for improving long-term outcomes. Additionally, recent data from the CDC highlights that Long COVID affects 6.4% of US adults, with nearly 20% facing significant activity limitations due to cognitive deficits.