Aspergillosis is a disease caused by Aspergillus, which is a variety of mould found in the air and soil. We all breathe in Aspergillus spores, and for most people these spores are harmless. However, they can cause major problems for those with immune deficiencies or lung conditions such as severe asthma, bronchiectasis, COPD, cystic fibrosis, and TB. Symptoms vary depending on the type of aspergillosis a person has, but can include weight loss, fatigue, fever, coughing blood (haemoptysis), breathlessness and, if untreated, can lead to deadly pneumonias. Aspergillosis is a very scary and life changing disease
When it comes to treatment, steroids are often prescribed to help reduce inflammation in the lungs. Antifungals are also used, and although they cannot eradicate the infection, they do reduce symptoms quite markedly in many cases. The main class of antifungals used are called azoles. As well as being the main medical treatment in the management of Aspergillus diseases, however, azoles are also used around the world as a pesticide. This wide use has brought with it a devastating unintended consequence. Just as bacterial infections are increasingly growing resistant to whole classes of antibiotics, the over use of azoles has led Aspergillus to develop resistance. This is a not only a disaster for farmers, who rely on azoles to control fungus in our food chain, but for Aspergillosis sufferers, as many of the alternative antifungal treatments available are not only expensive, but bring with them a host of unpleasant side effects.
The Aspergillosis Trust is a patient and carers group, whose main aim is to support all with this severe respiratory condition worldwide. As part of our work we are not only calling for better awareness among healthcare professionals and earlier diagnosis of new cases to enhance quality of life, improve outcomes and reduce mortality, but also for more research to find new treatments, due to the problem of increasing resistance with existing antifungals.
The disparity in funding between fungal diseases and other more ‘glamorous’ diseases has been well documented. It is not only a case of more research being needed, however. We believe it is equally important to highlight the human impact of this ‘hidden’ condition by telling patient stories, raising their voices, and ensuring we never lose sight of the people who are affected.
Jill Fairweather is a co-founder of the Aspergillosis Trust