Tinea: First cases of highly contagious fungal infection reported, should we be worried?

Experts have warned 'the world is not prepared' after two women are the first to be infected with a highly contagious fungal disease.

The Centres for Disease Control and Prevention (CDC), reported the unidentified patients in the United States, aged 28 and 47, are the first known cases of the drug-resistant ringworm, also known as tinea.

The two women experienced large, scaly rashes on their neck, buttocks, thighs, and abdomen, and members of their families also exhibited symptoms.

Fungal infection spreading to Germany, Canada, and US

David Denning, Professor of Infectious Diseases in Global Health at the University of Manchester, said the infection, which can be transmitted easily between humans, is spreading across countries. He said:

Skin fungal infections are transmitted from one person to another in schools, homes and with intimate contact.

This new terbinafine-resistant fungus is a new species called Trichophyton indotineae and first identified in India.

The huge Indian diaspora has already seen this fungus spread to other countries including Canada and Germany, and now the USA.

What is tinea and what are the symptoms?

According to Better Health, tinea is a contagious fungal skin infection, also known as ringworm (however, there is no actual worm involved). All fungi like tinea require warm, moist environments to thrive. This is why it most commonly affects the hottest, most sweat-prone areas of the body, such as the feet, groin, scalp, and beneath the breasts.

Communal showers and changing rooms are examples of places where tinea may be likely to spread. The infection can be spread directly through skin-to-skin contact or indirectly via towels, clothes, or floors.

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The symptoms of tinea include, according to Better Health:

• Itching and stinging
• Red scaly rash that is shaped like a ring (annular)
• Cracking, splitting and peeling in the toe web spaces
• Blisters
• Yellow or white discolouration of the nails
• Bald spots on the scalp.

Denning added:

The infection itself is obvious to see and highly inflammatory in the skin.

Read more ⋙ Health warning issued over fungal nail infections: Check for these common symptoms

'The world is not prepared' for 'epidemic of these skin infections'

Health experts said that the fungal infections, which are becoming increasingly common due to global warming, are resistant to some medications. Denning said:

For two decades, we have been treating these infections with oral terbinafine for 3 weeks, very successfully, until this new fungal species arrived.

The most plausible explanation for its emergence is the frequent use in India of topical terbinafine (cream and ointment), which doesn’t completely cover the infected area or penetrate deeply into the skin, allowing escape of resistant variants.

Fortunately itraconazole at a dose of 400mg daily is usually effective. But knowing if the fungus is or is not this unusual species and whether it is resistant to terbinafine or not requires specialised testing in a mycology laboratory.

It therefore seems as though we should be concerned about this latest development, as he warned:

There are not enough such laboratories, but there are rapid tests for resistance commercially available. The world is not yet prepared for what will likely become a slowly evolving epidemic of these skin infections.

Sources used:

Mirror: 'Warning 'world not prepared' as women infected with highly contagious fungal disease'

Mirror: 'Symptoms of highly contagious fungal disease to look out for and how its transmitted'

Better Health: 'Tinea'