As a drug-resistant fungal disease, Candida auris, adapts to the warmer climate, cases of it rise; up 214% in Kentucky in 2022

Cases of a potentially fatal fungal disease called Candida auris have increased by 1,200 percent since 2017 and the warmer climate could be to blame, Camille Fassett reports for The Associated Press and Grist.

All of Kentucky's 29 clinical cases of C. auris were reported in 2021 and 2022. However, there was a 214% increase between the years, with seven in 2021 and 22 in 2022, according to the Centers for Disease Control and Prevention. 

Fungal disease expert Arturo Casadevall, a microbiologist, immunologist and professor at Johns Hopkins University, told Fassett that humans normally have tremendous protection against fungal infections because of our temperature. 

“However, if the world is getting warmer and the fungi begin to adapt to higher temperatures as well, some … are going to reach what I call the ‘temperature barrier’,” he said, referring to the threshold at which mammals’ warm bodies usually protect them from infection.

In other words, Fassett writes, "Over time, humans may lose resistance to these climate-adapting fungi and become more vulnerable to infections. Some researchers think this is what is happening with C. auris." 

And while C. auris is not usually dangerous for healthy people, it can be for older patients, people with pre-existing medical conditions and people in health-care settings. The death rate is estimated to be between 30% and 60%, according to the CDC. 

The pathogen was first identified 14 years ago in Japan and early on most cases in the U.S. were linked to people who had traveled from other places, Meghan Marie Lyman, an epidemiologist for mycotic diseases at the CDC, told Fassett. Now, she said, most cases are acquired locally, generally spreading among patients in health-care settings.

"In the U.S., there were 2,377 confirmed clinical cases diagnosed last year," Fassett reports. She adds, "In the U.S., the most cases last year were found in Nevada and California, but the fungus was identified clinically in patients in 29 states. New York remains a major hot hotspot."

Dr. Luis Ostrosky, a professor of infectious diseases at McGovern Medical School at UTHealth Houston, told Fassett that he thinks C. auris is “kind of our nightmare scenario.”

“It’s a potentially multidrug-resistant pathogen with the ability to spread very efficiently in health care settings,” he said. “We’ve never had a pathogen like this in the fungal-infection area.”

The problem is so bad that the CDC issued a news release in March, calling the fungus "an urgent antimicrobial resistance (AR) threat" and noted that it "spread at an alarming rate in U.S. health-care facilities in 2020-21." 

"CDC has deemed C. auris as an urgent AR threat, because it is often resistant to multiple antifungal drugs, spreads easily in health-care facilities, and can cause severe infections with high death rates," the release says.

The article is published in Grist, an online journal of environmental news and commentary, as part of a collaboration with AP called Climate Connections, to explore how a changing climate is accelerating the spread of infectious disease around the world, and how mitigation efforts demand a collective, global response.

Kentucky is one of the most sleep-deprived states; Appalachian Ky. is even more so, and that affects people's health and safety

Screenshot of interactive map; for the interactive version, with county-by-county figures, click here.

Kentucky is one of the leading sleep-deprived states, ranking fourth in the percentage of adults reporting that they get less than seven hours of sleep per day, 40.5 percent. So says the 2020 Behavioral Risk Factor Surveillance System survey, a continuing national poll by the Census Bureau. The U.S. rate was 34.8%.

Even fewer adults in Kentucky's Appalachian counties are getting enough sleep. CDC data from 2018 shows that between 40.6% to 49.1% of people living in the region reporting they get less than seven hours of sleep per day. McCreary County's 49.1% was the highest in the nation.

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults sleep at least seven hours a night. 

The CDC reports that the percentage of adults who had trouble falling asleep most days or every day in the past 30 days was highest outside metropolitan areas (17.1%). Adults in nonmetro areas also had the highest rate for having trouble staying asleep (22.4%). 

Dr. Kay Miller Temple took a look at the impact of sleep on rural America's health and safety for The Rural Monitor, published by the Rural Health Information Hub. Rural doctors told her that while sleep problems presented as a primary concern for many of their patients, their trouble sleeping was often related to other conditions, both physical and mental. 

“Sleep also shows up as ‘incident to’ other presenting complaints,” Dr. Jennifer Brull, a recently retired family medicine physician from Plainville, Kansas, told Temple. “For example, when you’re working with a patient on addressing blood pressure that’s too high, or diabetes that’s poorly controlled, or mental health conditions like depression and anxiety, a sudden change in the stability of chronic conditions is often linked to sleep patterns.”

Talking about sleep is a great way to open the discussion about other sensitive topics, like substance use disorder and mental health, board-certified clinical psychologist Tess M. Kilwein, who operates a teletherapy practice with 75% of her patients located in rural areas of four states, told Temple. 

Dr. Lois Krahn, a psychiatrist, sleep medicine specialist and medical educator, told Temple that sleep deprivation can result in people being "really unhappy, irritable, reactive, and just overall miserable." She said people in rural areas might only get three hours of sleep during harvest time or if they do shift work.

One challenge for rural people who are sleep-deprived is that they have to drive longer distances in an unchanging landscape to do anything, and that often includes commuting long distances to do shift work, Brull told Temple.

“We know from the National Highway Traffic Administration that drowsy-driving crashes and fatalities are more common in rural areas,” Anne Wheaton, deputy associate director for Science in the Division of Population Health at the CDC, told Temple. 

One reason seniors in rural areas fall asleep so often is because they are bored or because they don't have any social interaction, Dr. Evin Jerkins told Temple. 

"If they live an hour out on a country road, there are no local activities to attend, so I find out when they’re most likely to fall asleep, and together we figure out a practical activity to slot into that time, like calling friends and family," said Jerkins. 

And an unexpected reason that is contributing to people getting less sleep is climate change, Kasha Patel reports for The Washington Post. 

Researcher Nick Obradovich, principal investigator at the Max Planck Institute for Human Development in Germany, and his colleagues found that "humans are already losing shut-eye in warm environments, especially at the beginning of the night. Models predict a solid sleep will further decrease as temperatures rise, especially in lower-income and elderly communities," Patel reports..

The study looked at 47,000 adults in 68 countries and found there were "notable change in sleep duration when nighttime temperatures rose above 50 degrees (10 degrees Celsius). On nights above 86 degrees, people slept about 14 minutes less on average," Patel writes.

This story has been fixed to reflect the correct publisher of The Rural Monitor.

Sneezing? Sniffling? Climate change means U.S. allergy seasons last a month longer than in 1990 and have 21% more pollen

Medical News Today photo

By Laurel Swanz
Kentucky Health News

With allergy season in full swing in Kentucky, those suffering from nasal allergies and asthma may feel as though the pollen gets worse every year.

The American College of Allergy, Asthma and Immunology says there is some truth to this – and climate change, which is causing warmer temperatures, longer growing seasons and decreased air quality, is to blame.

Pollen season starts earlier and lasts longer than in previous years, according to research led by William Anderegg of the University of Utah School of Biological Sciences and the National Institute of Food and Agriculture.

Andregg’s research found that pollen seasons “start 20 days earlier, are 10 days longer, and feature 21% more pollen than in 1990.”

Kentucky has had a longer pollen seson this year because it had an unseasonably warm February, putting parts of the state in bloom for months, according to Lexington's WKYT-TV.

“The strong link between warmer weather and pollen seasons provides a crystal-clear example of how climate change is already affecting peoples’ health in the U.S.,” Anderegg said in a report for the National Institute of Food and Agriculture.

According to Anderegg’s research, the warming temperatures confuse plants’ internal timing, or phenology, causing them to start producing pollen earlier in the year.

That means people who suffer from seasonal allergies and asthma and their health-care providers must start preparing sooner, as many treatments take varying amounts of time before becoming effective.

For example, immunotherapies to treat allergies through dissolving tablets or shots can take anywhere from 12 weeks to years to become effective, so knowing when allergy season is coming is essential to the timing and effectiveness of these treatments.

The Mayo Clinic offers several strategies to relieve seasonal allergies before resorting to allergy shots, including staying indoors when pollen counts are high to reduce exposure and using over-the-counter remedies such as antihistamines, decongestants and nasal irrigation.

The American College of Allergy, Asthma and Immunology reports that allergies and asthma often go hand in hand. And because climate change leads to heightened symptoms of both conditions, people need to know what they’re dealing with and how to treat it.

“What many people don’t realize is that the same things that trigger your seasonal ‘hay fever’ symptoms – things like pollen, dust mites, mold and pet dander – can also cause asthma symptoms,” allergist Kathleen May said in an ACAAI news release. “If you have allergies, and you are wheezing or coughing, an allergist can determine if you also have asthma. Allergists are specialists at treating asthma and can put together a treatment plan to help you deal with both conditions.”

Anderegg’s research found that climate change’s contribution to increasing pollen counts is only rising.

“Climate change isn’t something far away and in the future. It’s already here in every spring breath we, and increasing human misery,” Anderegg said in the report. “The biggest question is — are we up to the challenge of tackling it?”

Senate passes bill to limit Medicare drug costs, keep Obamacare discounts; Ky. senators vote no, citing tax increases, inflation

Kentucky Health News

Senate Democrats passed a bill Sunday titled the Inflation Reduction Act, which would allow Medicare to negotiate with drug manufacturers to lower prices, as well as limiting out-of-pocket drug costs for Medicare beneficiaries and continuing pandemic-lowered rates for federally subsidized health insurance.

Mitch McConnell and Rand Paul of Kentucky joined all other Republican senators in voting against the bill, which would also pay for several measures to combat climate change. It passed the Senate on Vice President Kamala Harris's tie-breaking vote and is expected to pass the House this week.

The bill targets climate change mainly through tax credits for electric vehicles, and would be paid for with "substantial tax increases, mostly on large corporations, including establishing a 15 percent corporate minimum tax and imposing a new tax on company stock buybacks," The New York Times reports. It also aims to boost tax revenue by boosting the payroll of the Internal Revenue Service.

Republicans said the economy is in recession, so it is no time to raise taxes, and cited official estimates that the bill would have little economic impact. McConnell said in a press release that Democrats' "response to the runaway inflation they’ve created is a bill that experts say will not meaningfully cut inflation at all. The American people are clear about their priorities. Environmental regulation is a 3% issue. Americans want solutions for inflation, crime, and the border."

Florida Sen. Rick Scott said on CBS's "Face the Nation" that because drug companies will have less money for research, "there will be lifesaving drugs that seniors will not get." Told that the Congressional Budget Office estimates that only 1% of drugs would be so affected, Scott said a viewer's grandmother might be in the 1%.

Those provisions would not take effect until 2026 and would apply to only 10 drugs, but would include more drugs in later years.

The bill would put a $2,000 annual cap on seniors' out-of-pocket costs for prescription drugs, and would guarantee that they could get vaccines without charge. Medicare patients would pay no more than $35 a month for insulin; the bill would have set the same limit for private insurance plans, but Republicans forced removal of that, based on the parliamentary rules governing the bill.

People on federally subsidized health insurance, known as Obamacare, would get three more years of the discounts that Democrats pushed into law last year and that would otherwise expire this fall, just before the annual enrollment period for Obamacare policies, held by about 90,000 Kentuckians.

American Academy of Pediatrics calls for systemic changes to decrease climate change because children's health is at stake

The American Academy of Pediatrics has called on pediatricians, the health sector and politicians to solve what it calls "the crisis of climate change" to protect children from its immediate and long-term health consequences, Ashley Welch reports for CBS News.

"There is nothing more important than protecting the health, welfare and future for our children and grandchildren," Dr. Samantha Ahdoot, lead author of the statement and member of the AAP's Council on Environmental Health Executive Committee, told CBS. "Climate change is about the world in which our children are living today and in which they will be raising their own families. Their future is at stake, yet they do not vote and they have no voice in the debate. We have a moral obligation to act on their behalf."

The AAP's policy statement breaks down the health consequences of climate change into direct and indirect effects.

Direct effects of climate change on children

Direct effects include those that result from extreme weather events, including severe storms, floods and wildfires that scientists say are occurring more frequently and on a larger scale because of climate change, the report says.

"Children's unique needs place them at risk of injury, death, loss of or separation from caregivers and mental health consequences due to severe weather events," Ahdoot told CBS News, who is also the assistant professor of pediatrics at Virginia Commonwealth School of Medicine.

For example, about 250,000 children were evacuated and relocated as a result of Hurricane Katrina, and more than 5,000 were separated from their families, with the last one reunited with their family six months after the storm, according to the report. This took "a toll on their academic performance, behavior and mental health," Welch writes.

The report also notes that heat waves are lasting longer and are more severe, particularly putting infants and high school athletes at risk of heat-related illness and death. Annually, 9,237 cases related to heat are reported nationally in high school athletes, Welsh reports.

Indirect effects of climate change on children

Indirect health concerns include respiratory diseases; lengthened allergy seasons; smoke from wildfires; and infectious diseases like malaria, dengue fever, West Nile virus and others that could see more favorable conditions in a warmer climate. Increased transmissions risk of Lyme disease in the northeastern U.S. has been linked to climate warming in that area, says the report.

Climate change also alters agricultural conditions, which affects food availability and cost, further threatening the nutrition needs of children around the world, says the report. Added to that, the nutritional value of foods is changing because of increased carbon dioxide in the atmosphere, says the report.

"The report emphasized that children in the world's poorest countries, where health burdens due to disease and malnutrition are already disproportionately high, are most affected by climate change," Welsh writes.

The authors also note that climate change can cause population displacement and communities to fail, and thus will contribute to global instability and a potential increase in violent conflict.

Call to action

Based on "well-established evidence" that human-generated greenhouse gas emissions are the cause of climate change, the American Academy of Pediatrics calls for pediatricians, the health sector and governments to take action to address these issues, hoping that a universal concern about the health effects of climate change on children will drive this action.

"Failure to take prompt, substantive action, given our current knowledge, would be an act of injustice to all children," says the report.

AAP calls for the promotion of "energy efficiency and renewable energy production, surveillance and research on climate-associated health conditions, public awareness and education campaigns and funding for public transit and urban planning that supports open space, walkability and green building design," Welsh writes.

In selling proposed limits on CO2, Obama administration emphasizes health improvement, not climate-change fight

By Melissa Landon and Al Cross
Kentucky Health News

As it announced its plan to reduce carbon dioxide emissions from power plants by 30 percent by 2030, the Obama administration emphasized the health angle, not climate change, which has been the driving force for the proposed regulations but is a more controversial cause than improving health.

"For the sake of our families' health and our kids' future, we have a moral obligation to act on climate," EPA administrator Gina McCarthy said in her announcement.

Juliet Eilperin and Steven Mufson note in The Washington Post that when a climate bill stalled in the Senate four years ago, environmental and public health activists began pressuring Preisdent Obama to mandate carbon limits. Opponents to the measure include coal producers, some utilities and many Republicans, who say that the EPA has not proposed a plan that can work using current technology.

Under the new rules, states would use different strategies—such as energy efficiency, shifting from coal to natural gas, investing in renewable energy and making power plant upgrades—to achieve state-by-state goals. The reductions will be measured from 2005 levels; Environmental Protection Agency data reveal that power plants in the U.S. have already diminished carbon dioxide emissions by almost 13 percent since 2005, The Associated Press reports.

EPA estimates the rules will prevent as many as 6,600 premature deaths, 150,000 asthma attacks in children, up to 490,000 missed work and school days—saving $93 billion, Connie Hedegaard writes for EurActiv. The federal Centers for Disease Control reports that "exposure to particle pollution may cause worsening asthma symptoms, breathing problems, adverse birth outcomes, lung cancer and early death," Healio reports.

The new rules are intended to assist Washington in achieving international obligations to reduce U.S. greenhouse gas emissions deemed responsible for global warming, but Obama is focusing on the human health benefits to encourage Americans to adopt the movement, Jeff Mason wres for Reuters.

Although federal law has been employed to regulate other pollutants—such as soot, mercury and lead—this is the first time it has been applied to greenhouse gases, Fox News reports, quoting Obama: "We limit the amount of toxic chemicals like mercury, sulfur and arsenic that power plants put in our air and water. But they can dump unlimited amounts of carbon pollution into the air. It's not smart, it's not safe, and it doesn't make sense."