
Candida auris: A fungus hospitals don’t want to talk about - DVassallo
https://www.nytimes.com/2019/04/08/health/candida-auris-hospitals.html
======
gumby
I used to work on antifungal drugs (though not against C Auris) and I don’t
remember it being any sort of secret. It’s just not a sexy microbe.

Antifungal drugs tend to be very toxic for humans too, though luckily most
healthy people’s immune systems are pretty good at rejecting them.

~~~
el_benhameen
I think the point of the article is not that they're trying to find info on an
unsexy microbe. It's that hospitals and similar organizations don't want to
talk about antifungal-resistant C Auris because they don't want to be pegged
as "that hospital where people get candidiasis", and that secrecy is harmful
to the public's ability to find out about the problem.

------
dfeojm-zlib
_To eradicate it after one patient died, a hospital in Brooklyn even “had to
rip out some of the ceiling and floor tiles” in his room._

\- [https://slate.com/technology/2019/04/candida-auris-
hospitals...](https://slate.com/technology/2019/04/candida-auris-hospitals-
superbug-spread-prevention.html)

~~~
gingabriska
I wonder what if some developed countries release these viruses in developing
country with large population but not advance medical techniques. Would they
be able to see evolution making people survive against this deadly fungus?

Then simply understanding the mechanism might lead to development of new
drugs.

~~~
jbattle
Like polio, malaria, yellow fever, rotavirus, trachoma, hepatitis? Sadly we
have plenty of pathogens of all stripes in common circulation already.

Maybe I'm misreading what you wrote - but it kind of sounds like you are
suggesting we knowingly infect some developing country with additional
diseases, just to see what happens, in the hope it helps us make better
medicine for ourselves? That would be kinda ... twisted

~~~
BoorishBears
This person's comment from two days ago:

> If Norway wants to strive for sustainability they should be installing power
> plants in India and offering EVs and free charging ports there. In coming
> days, India is going to surpass all countries when it comes to net
> pollution.

> I don't know why these rich countries never do anything to improve quality
> of life on whole planet.

Hypocrisy at it's finest.

~~~
gingabriska
I am not here to take any position, I simply asked this because I suspect some
country might have this trick in their playbook.

I am not suggesting that countries should do this but I am expressing that it
might already be in someone's list of strategy to save their country from the
deadly virus.

------
rob74
I'm frankly surprised they should be surprised about this - wanting to talk to
a hospital about their issues with resistant germs is like asking a restaurant
about the roaches in their kitchen...

~~~
Dylan16807
People don't come into a restaurant pouring out buckets of super-roaches that
are immune to all normal methods of extermination.

If a restaurant has roaches it's their own fault. If a hospital has to fight
back a resistant germ it doesn't show they did anything wrong.

~~~
sambeau
People do go into restaurants with viruses though, and restaurants get treated
very harshly should people get infected from someone or some foodstuff there.

Restaurant's don't create viruses, they just pass them on, usually unwittingly
(and sometimes despite good hygiene practices) but one nasty outbreak traced
to a restaurant can destroy a reputation (and kill a business).

The classic case being Heston Blumetnthal's 'Fat Duck' restaurant where 240
people suffered gastroenteritis (nausea, vomiting and diarrhoea) due to
norovirus, probably carried in Oysters:

[https://www.theguardian.com/lifeandstyle/2011/dec/05/fat-
duc...](https://www.theguardian.com/lifeandstyle/2011/dec/05/fat-duck-
restaurant-noroviris-outbreak)

Who is to blame here? Maybe the Oyster farmer, but maybe the distributor. It
could have been a single employee with norovirus in the restaurant (or
anywhere in the distribution chain).

Most likely no-one did anything wrong and this was just "one of those things"

"We also received full support by our insurers who found no fault in our
practices following a report from a leading UK independent specialist. There
is still no guaranteed safety measure in place today to protect the general
public with regards to shellfish and viral contamination. For this reason we
still do not serve oysters or razor clams at the Fat Duck."

~~~
DanBC
Fat Duck was criticised for poor food hygiene practices.

> Restaurant's don't create viruses

They can dramatically amplify the viral / bacteria presence though. Norovirus
is pretty nasty (potentially fatal). Very small amounts of norovirus will
cause illness. This is why excellent hygiene is needed in restaurants.

Fat Duck was slow to respond to the incident; they had staff working who
should not have been working due to sickness; they were using the wrong
cleaning products.

[http://www.elizabethonfood.com/files/Liesbeth%20Auerbach/fil...](http://www.elizabethonfood.com/files/Liesbeth%20Auerbach/file/TheFatDuckRestauran-10_09_09.pdf)

~~~
sambeau
I think that's a fairly harsh reading of the report.

Saying "Fat Duck was criticised for poor food hygiene practices" is a little
different to saying "Several weaknesses in procedures at the restaurant may
have contributed to ongoing transmission."

The report simply says that they relied too heavily on using alcohol gels
which don't work so well on norovirus.

It also says that they are unsure if it was The Fat Duck's staff that
continued to infect customers or if the Oysters they continued to use
continued to be infected.

Yes, excellent hygiene is needed in Restaurants but excellent hygiene won't
always stop a norovirus.

One thing not mentioned here (that I suspect might be a factor) is that
restaurants that serve tasting menus are more at risk of causing an outbreak
like this. If everyone eats a large number of identical courses each with a
diverse number of ingredients the possibility of one of those ingredients
infecting a large number of people is surely greatly increased.

~~~
DanBC
Excellent hygiene won't always prevent norovirus, but it will prevent more
than 400 customers from getting it across several weeks.

------
neodypsis
The CDC has a web page where it keeps track of the number of cases, as well as
the geographical locations where they occurred [0]. Not currently there, but
Costa Rica appears to report a new case just recently.

[0] [https://www.cdc.gov/fungal/candida-auris/tracking-c-
auris.ht...](https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html)

------
jonathanjaeger
Luckily a couple biotech companies like Scynexis and Cidara Therapeutics are
working on some novel anti-fungals (currently in stage 3 trials). Hopefully
one or both make it through successfully and are approved by the FDA as cases
rise.

------
merricksb
A related article, published around the same time as this one, was posted and
got significant attention on HN about 2 months ago:

[https://news.ycombinator.com/item?id=19590180](https://news.ycombinator.com/item?id=19590180)

(Probably doesn't count as a dupe as this article is more about the secrecy
than the infection itself).

------
pstuart
The lack of transparency here is criminal.

~~~
edejong
By the hospitals or by the government unwilling to regulate disclosure?

~~~
eeZah7Ux
Both.

------
tomcam
Not trying to be cynical or arch or snarky here. But considering what
hospitals charge for things, isn’t it _relatively_ affordable to do drywall
work, tile replacement, etc.?

------
leptoniscool
Copper and silver are good for stopping bacterial growth :
[https://www.ncbi.nlm.nih.gov/m/pubmed/28407716/](https://www.ncbi.nlm.nih.gov/m/pubmed/28407716/)

Are there any materials can slow or stop fungal growth?

~~~
goldenkey
Baby powder works wonders for fungus. It destroyed jock itch when the azole
anti fungals couldnt. Just dry out the fungus if its external. Internal
fungals are an entirely different beast..

~~~
Raphmedia
Exactly. Fungus are usually quite straightforward to eradicate on the surface
of the body or on non-porous material. The issue with Candida auris is that it
gets in the patient's blood and inside the porous ceiling tiles and walls.

------
Fjolsvith
A workplace has to have Material Safety Sheets for hazardous chemicals that
people can review for safety precautions and dangerous effects (per OSHA). Why
wouldn't a hospital have something similar for communicable diseases?

~~~
giarc
They likely do. My hospital has patient handouts that cover common antibiotic
resistant organisms such as MRSA, VRE, CPO etc.

------
aszantu
We live in a world, where almost all skin care products contain anti-fungals.
People treat minor skin conditions with essential oils and teatree oil.
Fungicides are sprayed on the fields so the crop doesn't get infected and the
same is done with factory farmed animals. No wonder these things get
resistant...

~~~
neodypsis
It should be illegal to use fungicides or bactericides with medicinal value in
non-human applications, especially on crops. I'm feeling hopeless regarding
what our future chances are in fighting super-bugs. Could you elaborate more
on why using tea tree oil contributes to drug-resistant Candida?

~~~
masklinn
> It should be illegal to use fungicides or bactericides with medicinal value
> in non-human applications, especially on crops.

Fungi are one of the big crop killers. Potato blight, black pod disease,
panama disease, mildews, … are all fungi.

~~~
Dylan16807
I can't tell where you're going with this. Are you saying that there aren't
enough non-medicinal-value fungicides to use on crops? Did you misread the
sentence you replied to?

~~~
masklinn
> Are you saying that there aren't enough non-medicinal-value fungicides to
> use on crops?

There's going to be a significant overlap between fungicides which don't kill
crops and fungicide with medicinal value.

~~~
Dylan16807
Edit: Let me try rewriting this comment.

Sure, there's overlap. That doesn't answer the question.

Are you making that claim? Or saying that it's _likely_?

Your comment had a stance for a brief moment, but then you backed up to
"overlap exists" which isn't really evidence in any particular direction.

~~~
krageon
You appear to be really contrarian about this issue (which can be valuable)
for reasons unclear to me and from the looks of it the person you are
responding to, who you keep trying to peg as being just as contrarian when in
fact they really haven't said much that should be surprising.

Perhaps you can explain what exactly your stance on the subject is, and what
you think the person you are responding to is saying. Then you can explain why
that bothers you, perhaps then this person and the casual reader can take
something away from this discussion.

~~~
Dylan16807
What bothers me is that masklinn is saying statements that sort of imply there
should be a debate, but are not actually advancing the conversation at all.
They are neither stating a position nor introducing evidence toward a possible
position.

Maybe it helps if I go through the conversation:

Neodypsis says we shouldn't use medicinal-value fungicides on crops. A clear
position, based on obvious evidence.

Masklinn replies saying that fungi kill a lot of crops. Okay, well taken
literally that's already a part of the comment they reply to. Is the
implication that we need _medicinal-value_ fungicides for crops? So I ask if
that's what they're saying.

Their reply back... refuses to answer. They just say there's "significant
overlap", but "significant overlap" is almost nothing in terms of answering
that question. There could be tons and tons of usable crop fungicides outside
the overlap. Or none. So it's a fact that's useless by itself but deniably
implies a position.

And unless I'm going crazy they initially posted with a real position, but
immediately edited it out.

So what I see is someone who could contribute to the debate, almost did for a
brief flash, but would rather make posts that have no opinion and no relevant
facts. Noise instead of signal.

I don't think they're contrarian, I think those posts are some kind of
terrible opposite of being contrarian. And I'm not trying to be contrarian, I
just want them to clarify. As for fungicides I have no idea, I need more
evidence...

~~~
krageon
I think it's credible to say that they assumed that the reader would
understand that if there were only a few antifungals that could be used on
crops, they would start working very poorly in short order. That's not
exceptional, because we've seen it happen before with other compounds we spray
on crops.

Seen through this lens, I don't necessarily follow with your thinking - but I
can try now! Thank you for explaining it so well.

------
atian
Where the Candida albicans central crew at?

------
bayesian_horse
As compared to Kambucha, the fungus everyone wants to talk about.

------
okasaki
I think as journalists write more and more articles that are catastrophising,
clickbait-laden rubbish, they will find fewer and fewer people willing to talk
to them. This is a hole they dug for themselves.

~~~
cryptica
As far as I can see, there are no financial interests behind this article (in
fact, all the financial interests are against it because it's criticising the
lucrative medical system). Maybe it's slightly over dramatic but at least it
seems pure in its intentions and it's good to see that the writer feels
strongly about the topic.

This is real journalism and we need more of these articles. What we need fewer
of are articles which promote financial interests and drive wealth
centralization. These are abundant and nobody seems to be pointing those out.

