Deadly fungus likely to threaten Alberta hospitals and care homes, experts warn
4 cases of the superbug, Candida auris, confirmed in the province since 2020
A deadly, drug resistant fungus sparking concern in the United States has been detected in very small numbers in Alberta, and experts say vigilance will be key in the battle to prevent outbreaks in hospitals and care homes.
Calling it a "serious global health threat," the Centers for Disease Control and Prevention warned recently that Candida auris (C. auris) is spreading at an alarming rate in U.S. health-care facilities.
According to Alberta Health, four cases have been confirmed in the province since the fungus started being tracked as a "disease under surveillance" in 2020 (three in 2022 and one in 2021).
"It will be a threat here as it will be in every major health-care facility in the developed world," said Dr. John Gill, a Calgary-based infectious disease specialist.
C. auris, a yeast first identified in 2009 in Japan, can cause serious infections in people who are already very sick or immune compromised (including chemotherapy and transplant patients and those with invasive medical devices), often in hospitals and nursing homes.
And it can be resistant to multiple drugs.
"This is on everyone's radar. How common is it? Will it be as difficult to treat as we suspect? And how can we stop it spreading or emerging in our health-care system?"
Mortality rates for invasive C. auris infections — where the fungus infects the blood or organs — are estimated at over 40 per cent, according to the Public Health Agency of Canada (PHAC).
43 known cases in Canada
Across the country, 43 cases have been confirmed since 2012, including 21 cases in B.C. or Alberta, two in Saskatchewan or Manitoba, 19 in Ontario or Quebec and one case from the Atlantic region, PHAC data shows.
This includes both infected individuals and those who are carriers of the fungus. Some of the cases were associated with travel.
PHAC's surveillance shows most of the cases (35 of them) have been detected within the last five years, and one-third of Canada's known cases have been resistant to multiple drugs.
"Similar to the experience of other countries, it is possible that C. auris will become more common in Canada, including the potential for outbreaks in health-care and long-term care facilities," a spokesperson said in a statement emailed to CBC News.
PHAC said the risk to the general population is "very low" because healthy people don't typically become seriously ill with the pathogen.
"We are looking. We are aware.… Surveillance is key, and awareness that it's out there.… We may need to intervene more aggressively if it becomes a problem locally," said Gill, noting early diagnosis and testing will be necessary to prevent outbreaks.
No routine screening
Dr. Samir Sinha wants health-care systems across the country to heed the warning out of the United States.
"This is just another one of those superbugs that is spreading quite rapidly in the U.S. It's only a matter of time before we start seeing a rapid spread across Canada," said Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto.
"The key is we're not routinely screening for this and often we're missing the diagnosis," he said.
"If we actually know where it is and who has it, we can immediately put those infection prevention and control measures in place."
The trouble is, in addition to being difficult to treat, C. auris spreads very easily.
"It lives on surfaces. It's really hard to clean. And it really is one that spreads by contact," said Sinha, noting nursing homes are particularly vulnerable.
"These are usually places that are not well staffed and they don't actually have the time to do the right infection prevention and control measures," he said.
"If we put the right protocols in place … then we might actually have a fighting chance."
WATCH | A deadly, drug resistant fungus has already appeared in Alberta:
Alberta Health Services said it's keeping an eye on the situation. While routine screening for C. Auris is not currently in place, the AHS infection prevention and control team is developing a screening protocol in case it is needed.
"To date, these events are rare in Alberta. However, we will continue to monitor and will implement patient screening and protocols as needed."