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'Superbug' fungus resistant to major drugs is found in two cities

A 'superbug' fungus that is resistant to common drugs has been found in two hospitals and a nursing home, health officials have revealed.

The fungus was identified at a nursing home in Washington, DC and two hospitals in Dallas, Texas, according to the Centers for Disease Control and Prevention (CDC).

The two outbreaks included about 120 patients in total.

Of those, infections in five patients were resistant to all types of antifungal medications and three patients died.

This fungus is considered a 'serious global health threat' by the CDC, and evidence from these new outbreaks shows that it spreads from person to person - not just from treatments or hospital surfaces.

CDC officials announced new, drug-resistant fungal outbreaks in two Dallas hospitals and a Washington, DC nursing home on Thursday.

The fungus, called Candida auris, is a harmful form of yeast. It's considered dangerous to hospital and nursing home patients with serious medical problems.

'This is really the first time we've started seeing clustering of resistance,' said Dr Meghan Lyman, medical officer at the CDC.

In these 'clusters,' patients appear to be getting infections from each other. 

This is distinct from past outbreaks, when the fungus spread through direct contact with patients or on contaminated surfaces.

The CDC considers this fungus a 'serious global health threat' because commonly used drugs have little effect on infections.

In a 2019 outbreak, doctors found that three cases of infection with this fungus were resistant to a class of drugs called echinocandins. This drug type is considered a last line of defense.

A few infection cases in these 2021 outbreaks were similarly resistant to common antifungal drugs.

Among 101 cases at the Washington, D.C. nursing home, three were resistant to all three kinds of antifungal medications.

Among 22 cases at the two Dallas hospitals, two had this level of resistance.

Three of those patients died - both patients in Texas and one in Washington.

C. auris has become an increasing concern since it was first identified by the CDC in 2015.

By 2018, over 300 clinical cases had been identified in a year.

About 90 percent of those cases were resistant to at least one antifungal drug and 30 percent were resistant to at least two, according the CDC.

Between May 2020 and April 2021 alone, about 950 clinical cases have been identified.

California, Florida, New York, and Illinois are all hotspots for the fungus with over 100 cases identified during that 12-month period.

In past cases, there was no evidence that infection spread from patient to patient - so scientists concluded that drug resistance formed during treatment.

But during these new outbreaks, infection did spread from patient to patient, according to CDC investigators.

This finding indicates that the fungus may become an even greater public health threat in coming years. 

Reference: Daily Mail: Associated Press and Betsy Ladyzhets For Dailymail.Com

India reports more than 4,300 deaths from Covid-linked ‘black fungus’ infection

India has reported 4,332 deaths caused by mucormycosis, a condition commonly known as “black fungus” that has seen a dramatic uptick in the country since the start of a devastating second Covid wave.

The country’s health ministry revealed on Tuesday that the number of total individuals infected by this fungal infection has crossed 45,000 cases.

The ministry said that 20,277 patients are still under treatment, while 19,073 have recovered.

The condition is caused by a group of moulds called “mucormycetes” that are present in the air and cause complications in those with acute illnesses such as severe Covid, or in people with compromised immunity.

According to doctors, once inhaled, the infection in vulnerable patients could spread into the sinus cavities, lungs, and chest cavities.

Some of the signs and symptoms of the fungal infection include persistent pain and headaches caused when the fungus infects sinus cavities and nerves.

If not detected early enough, the disease can spread to the nose, eyes, jaw bone and even brain and require amputation of the affected body parts.

On Wednesday, a “black fungus” survivor named Lata Khandelwal shared her experience in a thread on Twitter. She revealed that while she is now free from the infection after battling it for three months, the “loss” caused by the fungus will “remain permanent” as she is required to cover her sinus palate with detachable parts.

Khandelwal also wrote that she has to be “without teeth for the next two months” as doctors “can’t give her permanent dentures” for the next “three to four years” as they await bone development.

“I should thank God for saving my life,” she wrote.

The fungus is believed to be more dangerous for those who have weakened immune systems, including diabetes patients and those who are taking steroids for a long period of time – one of the treatments for severe Covid cases.

Doctors have previously told The Independent that mucormycosis can be induced in Covid patients by the overuse of steroids, used generally to treat those who are critically ill. It is also more likely to affect those who are otherwise severely immunocompromised.

In the past 24 hours, India has seen 42,015 new cases of Covid-19. So far, 418,480 people have died of the disease in the country and there are still 407,170 active ongoing cases. 

Reference: Independent: Peony Hirwani

Heatstroke symptoms and treatment: The signs you need to know

3% pay rise for NHS staff in England attacked as 'paltry, appalling and shambolic'

A 3% pay rise from the government to NHS workers in England has been heavily criticised as "paltry", "appalling" and "shambolic" by union leaders.

Those receiving the increase, which is backdated to April 2021, include nurses, paramedics, consultants, dentists and salaried GPs.

The government says that for the average nurse, this will mean an additional £1,000 a year. And the extra sum is expected to equate to around £540 for cleaners and porters.

The workers are being recognised for their pandemic contribution during an "unprecedented year", says the Department of Health and Social Care (DHSC).

Health Secretary Sajid Javid has said it is a real-terms increase - but Donna Hales from campaign group Nurses United told Sky News: "It's not even an attempt at a pay rise."

She said she was "very insulted, very angry, very deflated, very disappointed... but to be fair, I'm not surprised."

She added: "We do need a proper 15% pay rise to bring us back in line."

Some unions, including the Royal College of Nursing (RCN), have described the sum as "shambolic" and "insulting".

The RCN added that "the profession will not take this lying down".

The organisation said the Treasury expects inflation to be 3.7%, so "ministers are knowingly cutting pay for an experienced nurse by over £200 in real-terms".

In a video on Twitter, Mr Javid said: "I'm sure that this pay rise will make a real difference to people's lives... showing them how much we value and respect their incredible contribution to our nation."

And in a statement, he said: "NHS staff are rightly receiving a pay rise this year despite the wider public sector pay pause, in recognition of their extraordinary efforts.

"We asked the independent pay review bodies for their recommendations and I'm pleased to accept them in full, with a 3% pay rise for all staff in scope, from doctors and nurses to paramedics and porters.

"We will back the NHS as we focus our efforts on getting through this pandemic and tackling the backlog of other health problems that has built up."

The government initially offered a 1% pay rise which was firmly contested by medical unions and regarded as "insulting" by NHS workers.

But on Wednesday evening, the DHSC confirmed they have accepted the recommendations of the NHS independent pay review bodies in full and will be increasing their offer to 3% in line with the "unique impact of the pandemic" on the health sector.

NHS staff in Wales will also receive the 3% increase after Health Minister Eluned Morgan also accepted the recommendations of the pay review bodies in full.

Healthcare staff have called for a real-terms pay increase.

And some may be disappointed that the amount falls short of the offer from the Scottish government, with NHS workers north of the border set to receive a 4% increase backdated to December.

Unison general secretary Christina McAnea said the pay award was "an improvement" on the government's "earlier, miserly 1% proposal", but that the sum "falls short of what NHS staff deserve after the past 16 months".

She added: "Porters, cleaners, nurses, paramedics and other health workers have waited for months for what they hoped would be a fair deal. Ministers could have paid up last year if they really valued the NHS. Instead, staff have been made to hang on until the summer - long after their wage rise was due."

The Royal College of Nursing interim general secretary and chief executive Pat Cullen said: "After a shambolic day, comes a shambolic announcement.

"When the Treasury expects inflation to be 3.7%, ministers are knowingly cutting pay for an experienced nurse by over £200 in real-terms.

"Hospitals and other parts of the NHS are struggling to recruit nurses and healthcare support workers. The Government has been warned that many more are on the verge of leaving. With today's decision, ministers have made it even harder to provide safe care to patients."

Unite national officer for health Colenzo Jarrett-Thorpe described the 3% pay recommendation as "grossly inadequate and underwhelming".

And the GMB union said the "insulting" 3% pay rise offer had been "sneaked out as MPs are packing up for summer holidays".

Rachel Harrison, GMB national officer, said: "Hospitals and ambulance services are operating under extreme pressures due to rising demand and staffing shortages.

"Now, rather than focusing on staff welfare they are being advised to enter the workplace against self-isolation advice and now given this frankly appalling pay offer.

"This was the opportunity for government to turn their clapping into genuine recognition. Their response is paltry. They have failed spectacularly.

"NHS workers know their worth and so do the public - shame on the government who don't."

Labour health minister Justin Madders said "once again, this government has had to row back on a shoddy, ill-thought through position".

"The pay review body has done what Ministers could and would not do - recognise that our NHS staff absolutely cannot be given a pay cut. After their hypocrisy, applauding NHS workers while trying to cut their pay, the government must make our NHS and key workers feel supported and valued after all they have done for us," he said.

Meanwhile, national chair of the Police Federation Jonh Apter called it an "insult" that officers were not also included in the pay rise.

"I don't begrudge a single penny of the 3% pay rise for our NHS colleagues," he posted on social media.

"But for my colleagues, those police officers who absolutely played their part during the pandemic, to be ignored by a pay body which has had its hands tied by government is the ultimate insult."

The government was facing a backlash after failing to announce an expected pay rise for NHS staff in England despite confirmation of the offer being widely expected on Wednesday.

Ms Whately delivered a ministerial statement on the NHS in the Commons on Wednesday afternoon, but her opening statement omitted any mention of the pay dispute.

But while the expected announcement failed to materialise in the Commons, the government did answer calls for the offer to be published before MPs break up for the summer recess on Thursday afternoon.

Sophie Morris, political reporter