Aspirational targets for aspergillosis announced on World Aspergillosis Day
January 31 2018
At the conference opening session Professor David Denning, president of the Global Action Fund for Fungal Disease (GAFFI), spoke on behalf of patients, doctors and researchers in calling for radical improvements. In so many countries and cities, hundreds of thousands of people die or are disabled by aspergillosis, yet with better access to diagnostics they could be saved or cured. He said:
"I have been looking after patients with aspergillosis for over 35 years, and yet we still lose patients and see too many people being severely affected by this common fungus. I contributed to many clinical studies bringing the first effective oral drugs (itraconazole and voriconazole) to patients, and yet the burden and number of deaths remains huge. Nothing less than a concerted international effort is required to address huge disparities in aspergillosis outcomes and frequency."
Other major needs for health improvements in aspergillosis include:
- Keeping homes dry and free from Aspergillus and other moulds, to reduce the number and severity of asthma cases
- Keeping hospitals free of Aspergillus, especially on wards with immunocompromised patients
- Reducing azole resistance with reduced use of azole fungicides in non-essential crops
- Preventing a new epidemic of resistance with any new class of antifungal used for aspergillosis by not allowing such chemical classes to be used as a fungicide
- Improving surveillance and detailed epidemiology data
- Developing immunotherapies as well as vaccines
This year marks the 20th anniversary of the Aspergillus & Aspergillosis Website, which is supported by the Fungal Infection Trust. At >100,000 pages, it provides a truly encyclopedic resource and news feed to the world at no cost to the user, thanks to its many supporters over the decades. Together with its sister site, Support for People with Aspergillosis, they attract over 125,000 users per month, which underscores the desperate need for this information. This year will also mark the 5th anniversary of LIFE Worldwide, a global fungal education website in English and Spanish that was launched by the Fungal Infection Trust to provide free news and resources for all fungal diseases.
The biennial Advances Against Aspergillosis conference series is the premier forum for detailed and dedicated discussion of all aspects of aspergillosis, attracting >350 delegates from >35 countries. Topics frequently discussed include: pan-azole and echinocandin resistance; new opportunities for both antifungal agents and immunotherapies in chronic and allergic aspergillosis; better molecular and low-cost strategies for diagnosis; publication of detailed clinical guidelines for clinicians.
Patients are often diagnosed with one of the several different types of aspergillosis after a considerable time spent being treated for different medical problems for example tuberculosis or asthma. Aspergillosis is often only considered when treatment for their pre-existing condition becomes ineffective, and by that time aspergillosis can be well established. There is a pressing need for tests that may diagnose aspergillosis in all its forms more quickly. As we discover more about the genetics of vulnerability to aspergillosis it may also be possible to start screening high-risk populations for early treatment.
Nasilele describes her experience of living with CPA after a prior diagnosis of Tuberculosis and then having a severe cough that did not respond to antibiotics.
This patient describes his experiences with childhood asthma and Allergic Bronchopulmonary Aspergillosis (ABPA). After persistent chest infections and continuous steroids and a bad productive cough, Aspergillus was cultured from his sputum in 2002. His difficulties with adverse effects caused by his antifungal treatment illustrate the need for new, alternative medication.