King County Public Health officials confirmed Tuesday that the first known outbreak of a specific deadly fungus has hit Washington state.
The fungus, called Candida auris or C. auris, first appeared 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 other cases were found at that time.
Another C. auris infection was confirmed in a patient recently admitted to Kindred, the public health agency said in a blog post this month. 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, such as C. auris, the post said.
More than a week later, three more cases were confirmed at the hospital, all of them in patients who had tested negative for the fungus when they were first admitted, meaning the infection was beginning to spread in the first known outbreak of C. auris in the state.
Public health officials said they were not yet sure of the initial source of infection, adding that it “may never be identified.” No other information about the patients was immediately available.
“Public Health continues to work with Kindred to help limit the spread of the disease,” the post read. “This includes keeping patients who test positive for C. auris away from other patients to reduce the risk of spread and using specific disinfectant cleaning products that are effective for C. auris.”
Kindred is currently notifying other facilities that have received patients who were previously at Kindred.
C. auris infections are considered an urgent public health threat and are spreading 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.
C. auris is particularly concerning because it is resistant to common antifungal medications, Claire Bostrom-Smith, director of King County’s health care-associated infection program, said in a blog post. It can also spread in the body without the patient experiencing any symptoms, a process called “colonization,” Bostrom-Smith said.
Bostrom-Smith added that between 5% and 10% of patients “colonized” with C. auris will eventually develop an “invasive” infection that can be serious. 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, Bostrom-Smith said, largely because they tend to be very sick and dependent on devices such as catheters or breathing tubes.
In general, C. auris does not pose a threat to healthy people, according to the CDC.
Symptoms generally include infections in different parts of the body, including the bloodstream, open wounds, and ears, although this depends on the location and severity of the infection, the CDC says. The agency noted that some symptoms may be similar to others caused by the bacteria, adding that “there is no common set of symptoms” for C. auris infection.
Bostrom-Smith added that fungi can also be difficult to get rid of in healthcare settings because they can live on some surfaces for weeks or longer.
Because public health teams had been working with Kindred for months to implement the early screening program, they expected to eventually find C. auris bacteria in Washington, the newspaper reported Tuesday.
“Early identification is key to controlling the spread of C. auris so that prevention strategies can be put in place before it spreads widely,” according to Public Health – Seattle and King County.