...By Henry George for TDPel Media.
First Confirmed Cases of Drug-Resistant Ringworm Highlight Global Unpreparedness
Medics have raised an alarming concern that the world is ill-equipped to handle a highly contagious fungal disease, as the first two cases of drug-resistant ringworm have been identified.
The infected individuals, two women aged 28 and 47 in the United States, have been diagnosed with the drug-resistant strain of tinea, commonly known as ringworm.
Disease Control and Spread of the Drug-Resistant Fungus
The Centers for Disease Control and Prevention in the USA have officially confirmed these cases.
Both patients exhibited lesions on various parts of their bodies, including the neck, buttocks, thighs, and abdomen.
Disturbingly, family members of the patients also experienced symptoms, suggesting the ease of transmission.
David Denning, a Professor of Infectious Diseases in Global Health at the University of Manchester, revealed that this infection, which spreads easily in schools and homes, is rapidly disseminating across countries.
He explained that skin fungal infections, including this new terbinafine-resistant fungus called Trichophyton indotineae, are transmitted from person to person in close contact environments such as schools and households.
The fungus was initially identified in India, but it has already spread to other countries, including Canada, Germany, and now the USA, mainly due to the substantial Indian diaspora.
Symptoms, Diagnosis, and Treatment Challenges
The first case involved a 28-year-old woman who noticed rashes appearing on her body during the summer of 2021.
Seeking medical attention in December, she presented with large, scaly rashes across her body.
Despite receiving antifungal treatment in January 2022 after giving birth, the prescribed medication did not yield any improvement.
Eventually, a four-week course of itraconazole was administered, which successfully cleared the rash.
Officials believe that the infection was acquired locally in the USA, as the patient had not recently traveled abroad.
In the second case, a 47-year-old woman experienced extensive rashes while traveling in Bangladesh.
Upon her return to the US, applying creams did not alleviate the condition.
Seeking medical help, she visited a medical center on three separate occasions in late 2022 as the rashes continued to spread.
Dermatologists eventually prescribed two four-week courses of medication, which improved the rash by 80 percent.
The patient, living with her husband and son, also exhibited symptoms consistent with ringworm, including widespread, scaly ring-like rashes on the thighs and buttocks.
Testing confirmed the presence of the Trichophyton indotineae strain, which is currently causing havoc in India and other parts of South Asia.
Treatment Challenges and Global Preparedness
Professor Denning explained that until the arrival of this new fungal species, infections of this nature had been successfully treated with oral terbinafine for three weeks.
However, the frequent use of topical terbinafine (cream and ointment) in India, which does not fully cover or penetrate deeply into the infected area, has likely allowed the emergence of resistant variants.
Fortunately, treatment with itraconazole at an appropriate dosage typically proves effective.
However, specialized testing in mycology laboratories is required to determine if the fungus is the unusual species mentioned and whether it is resistant to terbinafine.
Furthermore, Professor Denning highlighted that the world remains unprepared for the impending epidemic of skin infections due to rising global temperatures driven by climate change and the emergence of resistant medications.
He emphasized the scarcity of laboratories equipped to handle such testing and the urgent need for commercially available rapid resistance tests.
The current lack of preparedness raises concerns about the slow but inevitable spread of these skin infections on a global scale.
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