Guidance for Investigating Fungal Disease Outbreaks | Fungal Diseases

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tabindex="-1"> <a data-post-id="26254" href="/fungal/php/case-reporting/index.html" tabindex="0"> Reportable Fungal Diseases by State </a> <a data-post-id="26255" href="/fungal/php/guidance-investigating-outbreaks/index.html" tabindex="0"> Investigating Fungal Disease Outbreaks </a> <a class="view-all" href="/fungal/site.html"> View All </a> </div> </div> </header> <main class="container cdc-main" role="main" aria-label="Main Content Area"> <section class="cdc-page-title-bar cdc-page-offset noindex"> <time class="cdc-page-title-bar__item cdc-page-title-bar__item--date" datetime="2024-05-08 04:00:00"> May 8, 2024 </time> </section> <div class="cdc-page-title cdc-page-offset syndicate"> <h1>Guidance for Investigating Fungal Disease Outbreaks</h1> </div> <div id="content" class="cdc-page-content cdc-page-offset syndicate container"> <div class="cdc-dfe-body "> <div class="cdc-dfe-body__top "> <div class="dfe-section dfe-section--page-summary summary-blurb summary-list" data-section="cdc_generic_summary"> <div class="dfe-section__header"> <h2>Key points</h2> </div> <div class="dfe-section__content"> <ul class="nested-list"> <li class="level-1">Fungal disease outbreaks are rare.<ul> </ul> </li> <li class="level-1">Outbreaks can occur in healthcare settings and workplaces. Some have occurred following extreme weather events.<ul> </ul> </li> <li class="level-1">Health departments and healthcare providers can contact CDC for support with outbreak prevention and response.<ul> </ul> </li> <li class="level-1">The National Outbreak Reporting System (NORS) collects reports for outbreaks of blastomycosis, coccidioidomycosis, histoplasmosis, and sporotrichosis.<ul> </ul> </li> </ul> </div> <div class="dfe-section__image" id="page-summary-image"> <figure class="dfe-image dfe-image__large"><div class="image-container calculated-ratio-16-9 aspect-ratio-16-9"><img src="/fungal/media/images/2024/05/347136_79_DiseaseReporting.png" alt="image of a government building, A pop out circle has a male doctor making a phone call. a circle on the other side shows a male public health official wearing a suit and tie and on a headset in front of a computer."></div></figure> </div> <div id="nav-buttons"> </div> </div> </div> <div class="cdc-dfe-body__center "> <div class="dfe-section" data-section="cdc_generic_section_1"> <a class="onThisPageAnchor" id="cdc_generic_section_1-action-steps" name="Action%20steps" title="Action steps"></a><h2>Action steps</h2> <p>Report any suspected or confirmed fungal disease outbreak to the local health department. Health departments can start investigations with assistance from CDC. </p> <h3>Local health departments</h3> <p>Healthcare providers and anyone who suspects a fungal disease outbreak should contact their state or local health department.</p> <p>For healthcare-associated outbreaks: contact your <a href="/healthcare-associated-infections/programs/index.html" class="">healthcare-associated infection (HAI) coordinator</a>.</p> <h3>CDC assistance</h3> <p><strong></strong> State and local health departments and healthcare providers can contact CDC for assistance including:</p> <ul class="nested-list"> <li class="level-1">Fungal laboratory diagnostics<ul> </ul> </li> <li class="level-1">Epidemiologic investigation<ul> </ul> </li> <li class="level-1">Clinical guidance<ul> </ul> </li> <li class="level-1">Outbreak response <br><ul> </ul> </li> </ul> <div class="dfe-block dfe-callout dfe-callout--calltoaction"><h3>CDC contact information for fungal disease outbreaks&lrm;</h3> <div class="dfe-callout__body"><div class="callout-desc"><p><a href="mailto:fungaloutbreaks@cdc.gov" class=""><strong>fungaloutbreaks@cdc.gov </strong></a>for mold-related and all other suspected or confirmed fungal disease outbreaks.</p><p><br></p><p><a href="mailto:candidaauris@cdc.gov" class=""><strong>candidaauris@cdc.gov</strong></a> for <em>Candida auris</em> (<em>C. auris</em>) outbreak prevention or response.<br><br></p></div> </div></div> </div> <div class="dfe-section" data-section="cdc_generic_section_2"> <a class="onThisPageAnchor" id="cdc_generic_section_2-healthcare-associated-outbreaks" name="Healthcare-associated%20outbreaks" title="Healthcare-associated outbreaks"></a><h2>Healthcare-associated outbreaks</h2> <h3><em>Candida auris</em></h3> <p>The fungus <a href="https://www.cdc.gov/candida-auris/index.html"><em>Candida auris</em> (<em>C. auris</em>)</a> has been linked to outbreaks in healthcare settings throughout the world and the United States. <em>C. auris</em> is especially challenging because it spreads easily and persists on surfaces a long time needing additional infection control measures.</p> <p>Find more information on <em></em><em></em><a href="/candida-auris/hcp/infection-control/invasive-infection-prevention.html" class=""><em>C. auris</em> infection prevention and control.</a></p> <h3>Molds (<em>Aspergillus </em>and mucoromycetes)</h3> <p>Rarely, mold can cause outbreaks in healthcare settings. Some outbreaks have been linked to local construction, ventilation systems, contaminated healthcare linen, and contaminated medical instruments.</p> <p>Find more information for<a href="/fungal/php/guidance-investigating-outbreaks/mold-healthcare.html" class=""> healthcare professionals on mold outbreaks</a>.</p> <figure class="dfe-image dfe-image__large"><div class="links-options"><span class="file-view d-none d-sm-inline image-modal"><a href="#">View Larger</a></span></div><div class="image-container calculated-ratio-1-1 aspect-ratio-16-9"><img src="/fungal/media/images/341503B_FDAW_mon_Carousel_fungalFacts_V15-04.png" alt="Image of a doctor at a patient's bedside. The patient has an IV and monitors. Text reads: Patients can get deadly fungal infections in healthcare settings. Some fungi can infect internal organs, tissue, or blood."></div> <div class="dfe-image-caption-container"><figcaption class="dfe-image-caption" id="caption-26518-66704eeb6dbac">Infection control prevents fungal infections in hospitals.</figcaption></div></figure> <h3>Contaminated medicines or medical devices</h3> <p>Infection protection and control measures prevent fungal infections during medical procedures. On rare occasions, medications or medical devices used for invasive procedures have been contaminated with disease-causing fungi. The fungi causing these outbreaks can be difficult to identify.</p> <p>Examples include two fungal meningitis outbreaks:</p> <ul class="nested-list"> <li class="level-1">Multistate outbreak linked to <a href="https://archive.cdc.gov/#/details?url=https://www.cdc.gov/hai/outbreaks/meningitis.html" class="">steroid injections, 2012</a>.<ul> </ul> </li> <li class="level-1">Outbreak linked to surgeries with<a href="https://archive.cdc.gov/#/details?url=https://www.cdc.gov/hai/outbreaks/meningitis-epidural-anesthesia.html" class=""> epidural anesthesia in Mexico, 2023. </a><ul> </ul> </li> </ul> </div> <div class="dfe-section" data-section="cdc_generic_section_3"> <a class="onThisPageAnchor" id="cdc_generic_section_3-environmental-and-occupational-outbreaks" name="Environmental%20and%20occupational%20outbreaks" title="Environmental and occupational outbreaks"></a><h2>Environmental and occupational outbreaks</h2> <p>Environmental fungi can also cause outbreaks, although it is rare. Outbreaks are defined as two or more cases linked to a common source. This may occur in a workplace, in particular at construction sites or in laboratories. Outbreaks can also occur following extreme weather events or at outdoor public settings like campsites. <a href="https://www.cdc.gov/fungal/cap/index.html" class="">Some fungal diseases</a> that have been associated with outbreaks include blastomycosis, coccidiomycosis (Valley fever), histoplasmosis, and sporotrichosis.</p> <h3>National Outbreak Reporting System</h3> <p>Health departments are encouraged to report outbreaks of blastomycosis, coccidioidomycosis, histoplasmosis, or sporotrichosis to the <a href="https://www.cdc.gov/nors/index.html" class="">National Outbreak Reporting System (NORS)</a>. Even small outbreaks (just two cases, for example) can be reported through the NORS platform.</p> <p>Anyone who suspects an outbreak should contact their local health department.</p> </div> </div> <div class="cdc-dfe-body__right page-right-rail"> <aside class="page-right-rail__static noindex" role="complementary"> <div class="on-this-page " data-sid=""> <h2 class="on-this-page__heading"> On This Page </h2> <div class="card-body"> <ul> <li><a href="#cdc_generic_section_1-action-steps">Action steps</a></li> <li><a href="#cdc_generic_section_2-healthcare-associated-outbreaks">Healthcare-associated outbreaks</a></li> <li><a href="#cdc_generic_section_3-environmental-and-occupational-outbreaks">Environmental and occupational outbreaks</a></li> </ul> </div> </div> </aside> <aside class="page-right-rail__dynamic noindex" role="complementary"> <div data-related-nav></div> </aside> </div> </div> <div data-journey-next></div> <section class="container page-mobile-bar"> <time class="page-mobile-bar__item page-mobile-bar__item--date" datetime="2024-05-08 00:00:00"> May 8, 2024 </time> </section> <div class="page-content-sources noindex"> <div class="page-content-sources__header"> <a data-action="summary" class="collapsed" href="#content-sources" role="button" data-bs-toggle="collapse" aria-expanded="false" aria-controls="content-sources" data-cs-toggle="">Sources</a> <a data-action="print" href="#print" class="d-none d-md-block" aria-label="print this page" onclick="window.print()">Print</a> <a data-action="share" href="#share" data-bs-toggle="dropdown" aria-label="share this page" aria-expanded="false">Share</a> <div class="dropdown-menu page-share-bar" data-popper-placement="bottom-start"> <a href="#" class="page-share-facebook"><span class="cdc-icon-facebook"></span></a> <a href="#" class="page-share-linkedin"><span class="cdc-icon-linkedin"></span></a> <a href="#" class="page-share-twitter"><span class="cdc-icon-twitter"></span></a> <a href="#" class="page-share-syndication"><span class="cdc-icon-rss"></span></a> </div> </div> <div class="page-share-container"> <div class="page-share-popup" id="page-share-popup" role="dialog"> <a target="_blank" title="Share to Facebook" rel="noreferrer noopener" class="page-share-facebook metrics-share-facebook" href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.cdc.gov"> <span class="sr-only">Facebook</span> <span class="cdc-icon-facebook-inverse"></span> </a> <a target="_blank" title="Share to LinkedIn" rel="noreferrer noopener" class="page-share-linkedin metrics-share-linkedin" href="https://www.linkedin.com/shareArticle?url=https%3A%2F%2Fwww.cdc.gov&title=Living%20with%20High%20Blood%20Pressure"> <span class="sr-only">LinkedIn</span> <span class="cdc-icon-linkedin-inverse"></span> </a> <a target="_blank" title="Share to Twitter" rel="noreferrer noopener" class="page-share-twitter metrics-share-twitter" href="https://twitter.com/share?url=https%3A%2F%2Fwww.cdc.gov&text=Living%20with%20High%20Blood%20Pressure"> <span class="sr-only">Twitter</span> <span class="cdc-icon-twitter-inverse"></span> </a> <a target="_blank" title="Embed this Page" rel="noreferrer noopener" class="page-share-syndication metrics-share-syndicate" href="https://tools.cdc.gov/medialibrary/index.aspx#/sharecontent/https://https://www.cdc.gov/fungal/php/guidance-investigating-outbreaks/index.html"> <span class="sr-only">Syndicate</span> <span class="fi cdc-icon-syndication-round"></span> </a> </div> </div> <div id="content-sources" class="page-content-sources__body accordion-collapse collapse"> <div class="callout callout-content-source" role="status"> <div class="callout-heading">Content Source:</div> <a class="cdc-block-link" href="/ncezid/index.html">National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)</a> </div> </div> </div> <section class="container related-pages related-pages__mobile"> <div data-related-nav-mobile></div> </section> </div> </main> <section class="site-footer container noindex"> <div class="row cdc-footer__inner"> <div class="col-lg-3 site-footer__heading"> <h2> <a href="/fungal/index.html"> <i class="cdc-icon cdc-fa-solid cdc-fa-house"></i> <span class="cdc-footer__super-title" aria-label="Fungal Diseases"> <a href="/fungal/index.html"> Fungal Diseases </a> <i class="cdc-icon cdc-fa-light cdc-fa-angle-right"></i> </span> </a> </h2> <p>Fungal diseases are increasing worldwide and more are becoming resistant to antifungal medications. 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