SEATTLE — The first known outbreak of a particular deadly fungus has hit Washington state, King County public health officials confirmed Tuesday.
The fungus, called Candida auris or C. auris, first emerged in the state in July, when a Pierce County resident tested positive for the fungus at Kindred Hospital, a long-term acute care hospital in Seattle, according to Public Health — Seattle & King County. No further cases were found at the time.
This month, another C. auris infection was confirmed in a patient who was recently admitted to Kindred, the public health agency said in a blog post. The patient was tested through a state Department of Health screening program that encourages early detection of multidrug resistant organisms, or organisms that can be resistant to treatment, like C. auris, the post said.
More than a week later, three other cases were confirmed at the hospital, all in patients who had tested negative for the fungus when they were first admitted — meaning the infection had started to spread in the state’s first known C. auris outbreak.
Public health officials said they were not yet sure of the initial source of the infection, adding that it “may never be identified.” No further information about the patients was immediately available.
“Public Health continues to work together with Kindred to help limit spread,” the post said. “This includes keeping patients who test positive for C. auris away from other patients to reduce risk of spread and using specific disinfecting cleaning products effective for C. auris.”
Kindred is in the process of notifying other facilities that received patients who were previously at Kindred.
C. auris infections are considered an urgent public health threat, and spread at an “alarming” rate during the coronavirus pandemic, the Centers for Disease Control and Prevention said last spring. The fungus was first reported in the United States in 2016, and was responsible for a 200% jump in infections between 2019 and 2021, The New York Times reported last year.
Claire Bostrom-Smith, manager of King County’s health care-associated infections program, said in the blog post that C. auris is particularly concerning because it is resistant to common anti fungal medications. It can also spread in the body without the patient having any symptoms — a process called “colonization,” Bostrom-Smith said.
Between 5% and 10% of patients “colonized” with C. auris will eventually develop “invasive” infections that can be serious, Bostrom-Smith added. More than 45% of people with invasive infections die within the first 30 days, Bostrom-Smith said.
Those in long-term acute care facilities are generally most at risk, largely because they tend to be very ill and rely on devices like catheters or breathing tubes, Bostrom-Smith said.
In general, C. auris is not a threat to healthy people, according to the CDC.
Symptoms generally include infections in different parts of the body, including in the bloodstream, open wounds and ears, though it depends on the location and severity of the infection, the CDC says. Some symptoms might be similar to others caused by bacteria, the agency noted, adding that there “is not a common set of symptoms” specific to C. auris infections.
The fungus can also be difficult to get rid of in health care settings because it can live on some surfaces for weeks or longer, Bostrom-Smith added.
Because public health teams have been working with Kindred for months to implement the early screening program, they expected C. auris would “eventually be found in Washington,” the Tuesday post said.
“Early identification is key to control the spread of C. auris so that prevention strategies can be in place before it becomes widespread,” according to Public Health — Seattle & King County.
