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What to know about candida auris, the drug-resistant fungus spreading in NJ

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A potentially deadly fungus is spreading at "an alarming rate" in hospitals, nursing homes and other health care facilities across the country and in New Jersey, which is home to one of the biggest concentrations of cases in the nation, according to a new Centers for Disease Control study published this week.

Candida auris has been shown to do the most harm to the elderly and immunocompromised patients mostly in health care settings where it can easily spread.

"We're now seeing it appear in a number of states so it's really something to be concerned about," said David Perlin, chief scientific officer of Hackensack Meridian's Center for Discovery and Innovation in Nutley.

First identified in Asia in 2009, the initial cases in the U.S. were detected mostly in New Jersey and New York beginning in 2016. Symptoms include fever and chills. More than one in three patients with an infection die usually after it spreads to the heart or brain.

What's the situation in New Jersey?

New Jersey was one of the first states to detect candida auris in 2016. Within three years, two-thirds of all cases in the U.S. were concentrated in New Jersey and New York City.

Since then the fungus has spread significantly. Nevada, California, Florida and other states now outpace New Jersey.

"I think we have a better handle on it now because we were one of the first to detect it," said Perlin, who is the editor of The Journal of Fungi.

The state Health Department has been tracking cases for several years "to prevent future spread in vulnerable populations across all health care setting types," said Nancy Kearney, an agency spokeswoman.

Where in NJ has the fungus been most prevalent?

Most of New Jersey's cases over the past six years have been concentrated in the northeast part of the state.

Union County has led the way with 455 cases, followed by Essex with 139, Bergen with 134, Middlesex with 128 and Passaic with 105.

Several of the state's western and southern counties have reported zero cases.

But Kearney cautioned that the total number of cases is likely underreported since the data only comes from health care facilities, not outpatient settings.

How does it spread and who is most vulnerable?

Candida auris can harm immunocompromised patients, including the elderly and chronically ill, especially in health care settings where it often spreads quickly, said Darin Wiesner, a Rutgers New Jersey Medical School professor who studies fungal disease.

The fungus can grow on the skin of caregivers and in other places, such as nasal cavities. It can also survive and spread on equipment and furniture surfaces, he said.

Is candida auris resistant to drugs?

Of the three classes of anti-fungal drugs, candida auris is resistant to one and is developing a resistance to the other two, Wiesner said.

But there may be some drugs in the regulatory pipeline that could make a difference.

"Thankfully, developing new anti-fungal drugs is a very active area of investigation among academic researchers," he said.

How do you contain it?

Standard infection control measures for health care facilities, such as having caregivers change gloves between seeing each patient and disinfecting surfaces, are among the ways to help stop the spread of candida auris, experts say.

Perlin said patients, especially those coming from nursing homes and other long-term care facilities, should be tested for the fungus as soon as they enter a hospital and again before they are transported back to their home.

Which states have had the most cases?

Here are the top 10 states by number of candida auris cases in 2022, according to CDC data:

This article contains information from USA Today.

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