Monday, 31 January 2011

Aspergillus fumigatus Causing Breathlessness in Mumbai

Recent weather conditions and smog in Mumbai, India (the location for the recent hit film Slumdog Millionaire) have triggered a wave of reports of people suffering breathing problems. Authorities blame the prevailing weather conditions which have been cool but humid (ideal for fungal growth) combined with record levels of particulates (dust, soot, spores etc.) over the last 5 days.

Mumbai, India
Environmental monitoring  shows that there are 60 to 70 very hazy smoggy days between November and February most years in Mumbai, so this is a long term problem that has peaked this year. Smog is a cocktail of toxic substances that can render sensitive individuals more vulnerable to infections, including lung infections.

Most patients reporting breathing difficulties are suffering from asthma, emphysema or chronic bronchitis and respond to treatment, but a significant minority  do not respond to treatment and are then referred to testing for fungal infection. 15-20% of all patients are found to be positive for Aspergillus fumigatus which causes symptoms similar to asthma.

Evidence is accumulating that A. fumigatus can grow in the lungs of some people, causing allergies in some, worsening the symptoms of asthma patients (Severe Asthma with Fungal Sensitivity, SAFS) and it is known that it can trigger long term illness in others (Allergic Bronchopulmonary Aspergillosis, ABPA) or much worse in patients who have recently had an organ transplant (Invasive Aspergillosis, IA) or who have pre-existing conditions such as Tuberculosis (Aspergilloma, Chronic Pulmonary Aspergillosis, CPA).

This hazard may well have had its cause contributed to by the smog in Mumbai. The hazards of smog have been reported before in connection with an increase in asthma rates, but levels of contact with Aspergillus have not been investigated in connection with this problem. Here we find that Aspergillus can be a major contributor to breathing problems caused by smog.

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