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Published on: March 19, 2019
Climate Change, Natural Disasters, and Cutaneous Fungal Infections
Aditya K Gupta1,2, Mary Thornbush2,3, Tong Wang2
1Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Abstract:
Fungal infections are an important source of morbidity and mortality that can manifest as superficial or invasive diseases. Diagnostic techniques for human fungal pathogens remain problematic, and multi-drug resistance is emerging. This review addresses the potential emergence of new fungal pathogens in changing environments and reported instances of cutaneous fungal infections after natural disasters. Global warming does more than increase the mean global temperature; it is associated with changing precipitation patterns and major climatic events. With natural disasters, niches are created for the proliferation of fungal pathogens affecting humans across previously existing geographical boundaries. Here, we reviewed reports of cutaneous fungal infections after natural disasters, including earthquakes, floods, tsunamis, hurricanes, and tornadoes. Of importance is the potential for thermal adaptation leading to the evolution of new human pathogens, exacerbated by the elevated environmental fungal levels in disaster situations. Studies have documented higher risks of contracting typical tinea infections, as well as opportunistic, trauma-related infections by environmental fungi. The latter is especially concerning due to atypical clinical presentations that could lead to treatment delays, antifungal resistance, and systemic complications. These support the importance of considering climate change as affecting the adaptation of these pathogens and the consequences of this change for human populations. A One Health framework should be advocated to address the impact of climate change on dermatological care.
Insights
Climate change is increasing fungal pathogen risks, leading to more cutaneous fungal infections after natural disasters. This necessitates a One Health approach to address evolving dermatological challenges.
Area of Science:
- Environmental science
- Mycology
- Public health
Background:
- Fungal infections cause significant morbidity and mortality, with diagnostic challenges and emerging multi-drug resistance.
- Environmental changes, including global warming and natural disasters, create new niches for fungal pathogen proliferation.
- Cutaneous fungal infections are increasingly reported following natural disasters, posing risks beyond typical tinea.
Purpose of the Study:
- To review reported cases of cutaneous fungal infections after natural disasters.
- To explore the impact of climate change on fungal pathogen adaptation and emergence.
- To advocate for a One Health framework to manage climate-sensitive dermatological issues.
Main Methods:
- Systematic review of literature on cutaneous fungal infections post-natural disasters.
- Analysis of environmental factors influencing fungal pathogen proliferation and adaptation.
- Examination of clinical presentations and treatment challenges of opportunistic fungal infections.
Main Results:
- Natural disasters facilitate the spread of fungal pathogens into new geographical areas.
- Elevated environmental fungal levels post-disaster increase risks of both typical and opportunistic infections.
- Atypical presentations of trauma-related fungal infections can delay diagnosis and treatment, leading to resistance and complications.
Conclusions:
- Climate change is a significant factor in the adaptation and emergence of fungal pathogens.
- Increased incidence of cutaneous fungal infections post-disaster highlights public health risks.
- A One Health approach is crucial for addressing the complex interplay between climate, fungal pathogens, and human health.
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