Aspergillosis Cases Rising in the U.S., New Data Shows

Aspergillosis diagnoses in the United States increased by more than 5% annually between 2013 and 2023, according to recent research published in Open Forum Infectious Diseases. This rise in cases, coupled with growing concerns about antifungal resistance, highlights the need for improved surveillance and diagnostic access for this potentially deadly fungal infection.

What is Aspergillosis?

Aspergillosis is an infection caused by Aspergillus, a common mold found both indoors and outdoors. While most individuals exposed to Aspergillus spores do not become ill, it can cause severe infections in individuals with underlying lung disease or weakened immune systems, including cancer patients and organ transplant recipients. The overall mortality rate associated with aspergillosis is approximately 20% .

Study Findings: A National Trend

The study, led by researchers from the University of California, Berkeley, analyzed electronic health record (EHR) data from over 76 million U.S. Patients across 142 health systems. Researchers identified 20,764 aspergillosis cases between 2013 and 2023, resulting in a population-based prevalence of 15.26 diagnoses per 100,000 person-years. The prevalence of aspergillosis increased by 5.3% annually before the COVID-19 pandemic, peaking at 18.04 diagnoses per 100,000 person-years in 2022.

Geographic and Demographic Disparities

The prevalence of aspergillosis varied significantly by location. Rhode Island had the highest prevalence, substantially exceeding the national average each year, while Utah had the lowest. Diagnosis rates were also higher among men (adjusted prevalence ratio [aPR], 1.37) and adults aged 65 and older (aPR, 4.95) compared to younger adults. Urban residents were also more likely to be diagnosed than rural residents (rural aPR, 0.86).

Interestingly, the study revealed shifts in prevalence based on race and ethnicity. While White patients were more frequently diagnosed prior to the COVID-19 pandemic, the increase in cases after 2020 was disproportionately observed among Hispanic or Latino individuals and other racial minority groups. Researchers suggest these differences may be linked to variations in baseline health, access to diagnosis and treatment, and the impact of the COVID-19 pandemic.

Challenges in Tracking Aspergillosis

Currently, aspergillosis is not a reportable disease in the United States, making it difficult to determine the exact number of cases . This lack of centralized surveillance hinders efforts to understand the true burden of the disease and implement effective public health strategies.

Implications and Future Directions

The findings of this study underscore the importance of increased awareness of aspergillosis, particularly among groups not traditionally considered high-risk. Expanding diagnostic access and improving fungal disease surveillance are crucial steps in reducing morbidity and mortality associated with this infection. Further research is needed to understand the factors driving the observed increases in aspergillosis cases and to develop strategies to combat antifungal resistance.

Key Takeaways

• Aspergillosis diagnoses in the U.S. Have been increasing by over 5% annually.
• The infection is particularly dangerous for those with compromised immune systems or lung disease.
• Geographic and demographic disparities exist in aspergillosis prevalence.
• Improved surveillance and diagnostic access are needed to address this growing public health concern.