Jacob Margolis
covers science, with a focus on environmental stories and disasters, as well as investigations and accountability.
Published April 3, 2025 5:00 AM
Retardant is dropped over the Palisades Fire. What's in that bright red cloud?
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David Swanson
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AFP via Getty Images
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Topline:
LAist partnered with USC researchers to test samples of Phos-Chek, the fire retardant dropped on the Eaton and Palisades fires. The results came back positive for heavy metals including arsenic, chromium, cadmium and lead.
Why it matters: More than 190 million gallons of fire retardant have been dropped across California since 2006, according to data from Cal Fire. It's an often used tool that both the fire agency and the U.S. Forest Service have called critical.
Is it dangerous? The risk for people with limited exposure, such as homeowners or hikers, is “very low," one expert told LAist. However, questions remain about chronic exposure for firefighters. Aquatic ecosystems, however, are a concern.
Company response: LAist shared the USC lab result with Perimeter Solutions, the retardant's manufacturer. Jeff Emery, president of global fire safety, said the company’s products, including Phos-Chek MVP-Fx, have passed extensive testing. He added that the amount of heavy metals found by LAist was far below limits set by the Environmental Protection Agency and “any concerning levels for human health and safety.”
Read on ... to learn how fire retardant is used and what it means for the environment and people's health.
Not long after the Palisades Fire broke out Jan. 7, firefighting aircraft began drawing bright red lines with fire retardant across the Santa Monica Mountains, in an effort to slow and contain the flames.
By the time the fire was out about three weeks later, the MD-87s, S-2Ts and mammoth DC-10s had performed more than 280 drops across 20 square miles, according to data from Cal Fire obtained via public records requests.
LAist partnered with researchers at USC to test samples of the fire retardant gathered from fire zones in the weeks after the Palisades, Eaton and Franklin fires where it remained on the ground.
Those tests found toxic heavy metals including lead, arsenic, cadmium and chromium, which can accumulate in the environment and pose risks to humans and wildlife, according to federal and state environmental agencies.
Fire authorities say retardant is a critical component of the firefighting arsenal.
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Mario Tama
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Tests USC conducted on LAist's behalf found the presence of heavy metals in unused retardant and in samples collected after the recent fires.
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Allen J. Schaben
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Los Angeles Times via Getty Images
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A product called MVP-FX, a variant of Perimeter Solutions' Phos-Chek, was the primary aerial retardant dropped on the Eaton and Palisades fires, according to the company.
The presence of heavy metals in MVP-Fx has not been previously reported.
LAist shared the USC lab results with Perimeter Solutions. Jeff Emery, Perimeter’s president of global fire safety, said the company’s products, including Phos-Chek MVP-Fx, have passed extensive testing. He added that the amount of heavy metals found by LAist was far below limits set by the Environmental Protection Agency and “any concerning levels for human health and safety.”
The presence of heavy metals isn’t noted in safety documents publicly shared by Perimeter Solutions.
Aircraft often drop more retardant than water each year on fires in California. From 2006 to 2024, more than 194 million gallons of various types of fire retardant were dropped by aircraft, according to data from Cal Fire.
“We don’t check into every single thing that’s in there,” said Chris Jurasek, deputy chief of tactical operations at Cal Fire.
He said his agency relies on the U.S. Forest Service to test and verify the safety of the retardants it uses. The use of fire retardants is a “critical” component of the firefighting arsenal, according to both Cal Fire and the U.S. Forest Service.
Why we had to run our own tests
Late last year, LAist requested samples of MVP-Fx from Cal Fire, the U.S. Forest Service and Perimeter Solutions, which manufactures the product, for the purpose of running an independent analysis for heavy metals. All declined.
“It’s not in our interest to share product with public or private agencies,” Jurasek said at the time. “You are not the first person to ask for us to give them fire retardant. It happens. It’s not something we do.”
Fire retardant coats laurel sumac in the Santa Monica Mountains after the Palisades Fire.
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Jacob Margolis
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LAist
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A bag of laurel sumac covered in Phos-Chek, gathered in the Santa Monica Mountains. It was later taken to USC for testing.
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Jacob Margolis
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LAist
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So over the next few months we gathered our own samples from the field.
After the Franklin, Eaton and Palisades fires were under control, I hiked to remote sites and collected vegetation, trash and dirt that had been caked with fire retardant. The samples were placed into baggies and taken to the Environmental Chemistry Laboratory at USC, where the fire retardant was tested for heavy metals.
Marella Schammel, a Ph.D. student, scraped dried red flakes into tubes filled with a diluted mixture of nitric acid and ran them through an inductively coupled plasma mass spectrometer.
Flakes of Phos-Chek were scraped into tubes along with diluted nitric acid for testing.
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Jacob Margolis
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LAist
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Arsenic, cadmium, chromium, copper, manganese, nickel, lead, antimony, thallium, vanadium and zinc were all found in the samples.
Emery told LAist that any trace heavy metals found in testing were “naturally occurring.”
Phos-Chek MVP-Fx is primarily made of ammonium phosphates, which are derived from phosphate. That rock, when mined, can contain trace amounts of heavy metals.
“There are no heavy metals added to any of our formulations,” Emery said.
Cal Fire, the U.S. Forest Service and Perimeter Solutions all dismissed the results of the testing — saying that the samples couldn’t be relied on because they were gathered in the field. That the potential for contamination by ash from burning structures and brush after the retardant was dropped from planes was too great.
Eventually, LAist obtained unused, unmixed MVP-Fx and verified the source and authenticity of the material.
What we found
Marella Schammel, a Ph.D. student at USC, prepares samples of Phos-Chek for testing.
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Jacob Margolis
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LAist
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Samples of Phos-Chek loaded into an inductively coupled plasma mass spectrometry machine for testing.
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Jacob Margolis
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LAist
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Like the materials collected in fire zones, this unused sample was sent to the USC lab.
Schammel processed the MVP-Fx and found the same heavy metals present as the field samples we gathered.
There were some differences. However, it’s unclear if those differences are due to contamination on the ground or if there’s a variance in the amount of heavy metals present in different batches of the product.
“I’m not too surprised,” said Daniel McCurry, professor of civil and environmental engineering, who oversaw the testing process. Last year he and Schammel analyzed another Phos-Chek variant — LC95 — and found heavy metals as well.
LC95 is one of several USDA approved retardants in use today and one of the variants manufactured by Perimeter Solutions. Cal Fire doesn't use the LC95 variant.
Those results — from tests sparked in part by questions I’d asked McCurry in 2019 about whether we should be concerned about what was in fire retardants — made me want to know more about what is in the fire retardants in use now.
In an effort to compare USC’s test results to the official safety testing required by the federal government, LAist reached out to both Perimeter Solutions and the U.S. Forest Service, an agency within the USDA, for detailed test results for MVP-Fx. Neither would provide them.
In a statement, the U.S. Forest Service said that retardants that qualify for use have to show “nondetectable or trace levels” of certain heavy metals. However, the test results are proprietary information protected by nondisclosure agreements.
'Let people know what they're dealing with'
LAist’s review of publicly available documentation related to MVP-Fx, including its safety data sheet — which is required to warn those who may come in contact with the product of potential risks — found no reference to the presence of heavy metals.
A firefighting aircraft drops fire retardant as the Palisades Fire burns amid a powerful windstorm in January.
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Mario Tama
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Getty Images
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After reviewing LAist’s results and the company’s safety data sheet, Claudia Polsky, director of the Environmental Law Clinic at UC Berkeley School of Law, said the company is likely in violation of multiple California laws and regulations including Cal OSHA standards, unfair competition law and Proposition 65.
“The Cal OSHA hazard communication standards require that a safety data sheet identify every hazardous ingredient in the product,” Polsky said. “Companies often resist disclosure requirements.
“To me this situation is disturbing if unsurprising.”
When asked about the safety data sheet, Emery said that the company works to “ensure compliance with all applicable regulatory requirements concerning our product.”
A firefighter stands amid vegetation covered in retardant in the hills of Mandeville Canyon in January.
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Valerie Macon
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AFP via Getty Images
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Some who regularly work with Phos-Chek said that LAist’s findings were a surprise to them.
“ The heavy metal thing, I can tell you, was news to me,” said Joel Lane, air tactical group supervisor with the Orange County Fire Authority. He’s worked in the industry for decades and has come in contact with different variants of Phos-Chek, both during preparation and when it’s been dropped on him by aircraft.
Lane said that he’s never been told or read in official documentation that heavy metals could potentially be present in retardant, which he finds upsetting.
He said the lack of transparency is concerning, but that it wouldn’t be the first time.
Lane feels firefighters were left in the dark about the risk of PFAS — long-lasting chemicals used in firefighting foam and in the heavy gear firefighters wear — that have been tied to elevated rates of cancer, according to the Environmental Protection Agency. Lane himself recently survived prostate cancer.
“ Be transparent, be open. Let people know what they're dealing with,” Lane said. It’s only then that they can make informed decisions about risks for themselves, he added.
LAist asked the U.S. Forest Service about potential risks to firefighters, to which they responded that “risk assessments of firefighter exposure to retardants do not indicate an increased risk for health effects,” pointing to a health assessment conducted by the agency, which includes MVP-Fx.
Although the assessment says risks are expected to be generally negligible, it doesn't explicitly mention heavy metal exposure. The U.S. Forest Service didn’t respond to whether heavy metal contamination was taken into consideration for the assessment.
Widespread safety concerns after the fires
As recent fires burned whole neighborhoods, thousands of homes were destroyed, leaving behind a toxic stew of materials from lead paint in older homes, wiring, batteries and other hazardous substances. The aftermath has been a concern for many in the region looking for a path to rebuilding.
Heavy metals can pose a serious health risk and have been tied to increased rates of cancer, as well as reproductive and developmental issues in humans.
That said, multiple health experts told LAist that the risk to members of the public exposed to the retardant when doing activities like hiking, is likely low, given the concentration of contaminants present in our samples.
“It should not be a reason for panic, but maybe it's a reason for caution,” said Dr. Ana Navas-Acien, professor and chair of Environmental Health Sciences at the Mailman School of Public Health at Columbia University, who reviewed the results.
Retardant coats a playground at a Mandeville Canyon home after the Palisades Fire.
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Valerie Macon
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AFP via Getty Images
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Fire retardant covers a pool and lounge chairs dropped from a firefighting aircraft.
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Justin Sullivan
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Sanjay Mohanty, associate professor of civil and environmental engineering at UCLA, agreed, saying that the risk for people with limited exposure, such as homeowners or hikers, is “very low.”
If you or your pets are exposed, it’s a good idea to wash it off.
Environmental effects
Retardant is a particular concern if it gets into aquatic ecosystems.
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Valerie Macon
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AFP via Getty Images
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Fire retardants can be particularly dangerous to aquatic ecosystems, according to a U.S. Forest Service environmental impact study published in 2011.
Once retardant enters waterways it can lead to elevated ammonia levels, which in turn can be toxic to salmon and trout. And there’s a possibility that an influx of nutrients from retardant can boost algal growth and create dead zones, killing off organisms there.
Because of these risks, the U.S. Forest Service prohibits the dropping of retardant within 300 feet of waterways, though it does happen. There have been more than 240 intrusions since 2012, according to another U.S. Forest Service environmental impact study from 2023.
However, even if the retardant doesn’t get dropped directly on waterways, it can get washed into them by rain. Heavy metals can settle in streams and ponds and potentially have devastating impacts on organisms there.
William Clements, a professor in the Department of Fish and Wildlife Conservation at Colorado State University, homed in on the cadmium LAist found in the MVP-Fx.
“ If even a small fraction of that ends up in that stream, that is cause for concern,” he said.
If you or your pets are exposed to fire retardant, it's a good idea to wash it off.
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David McNew
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Getty Images North America
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The heavy metal can get taken up by sponge-like algae, which is then eaten by aquatic insects such as mayflies and stoneflies, which can die when exposed to the cadmium. Exposure to the heavy metal can also inhibit their reproduction, growth and ability to emerge from streams, compromising a source of food for fish and birds, according to Clements.
“ The levels of metals will increase and will be bioconcentrated over time. Not now, but in a year, two years, maybe five years from now,” said Dmitri Deheyn, a marine toxicologist at the Scripps Institution of Oceanography.
“ People need to make the association that the impact is a lingering impact that will be diffused and diluted over time and space.”
In an effort to figure out how much heavy metal was spread throughout the San Gabriel and Santa Monica mountains during the Eaton and Palisades fires, LAist requested information on the total number of gallons of retardant dropped, from both the U.S. Forest Service and Cal Fire, via records requests. None were fulfilled.
If you’re in the firefighting world and have any samples of Phos-Chek or another type of fire retardant you’d like to share, please reach out.
Robert Garrova
explores the weird and secret bits of SoCal that would excite even the most jaded Angelenos. He also covers mental health.
Published April 19, 2026 5:00 AM
Jacaranda trees line a street in South Pasadena.
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David McNew
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Getty Images
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Topline:
You might have noticed a little more purple on your commute in Los Angeles recently. Turns out the jacarandas are putting on their annual show of blooms a little early this year.
Why? Originally from the tropics, jacarandas respond to changes in temperature. They typically flower in our region from late April to mid-June. But remember that sweltering heat wave we got in March?
Where are the purple hot spots? A couple years ago, a local data graphics editor created an interactive map so you can find the purple hot spots.
You might have noticed a little more purple on your commute in Los Angeles recently. Turns out the jacarandas are putting on their annual show of blooms a little early this year.
Originally from the tropics, jacarandas respond to changes in temperature. They typically flower in our region from late April to mid-June.
But remember that sweltering heat wave we got in March?
“They got the clear sign: ‘It’s over 90 [degrees], it’s hot out. Even though you weren’t quite prepared, it’s time to put out some flowers,'” Loral Hall, community forestry senior program manager at environmental nonprofit TreePeople, told LAist.
Hall said not only do jacarandas grace us every year with thick canopies and carpets of purple, they’re relatively drought tolerant, pest resistant and able to grow in urban areas (like in a small square patch of dirt surrounded by concrete).
“They’re attention-grabbers here in Southern California,” said Hall, who grew up in Hollywood and has childhood memories of playing with the fallen purple blooms at a local park. “In a place where we don’t have really obvious seasons, [jacaranda blooms] are a sign that warmer weather is on the way.”
Hall also shared a lesser-known fact about jacarandas: There’s a white cultivar, too. The white version is much more rare in L.A., though with some of the trees rumored to be in a non-public area of the L.A. County Arboretum, Hall said.
A jacaranda at the LA Arboretum.
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Katherine Garrova
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How’d they get here?
The jacaranda is native to the tropical and subtropical regions of Argentina and Brazil.
Josie Huang
is a reporter and Weekend Edition host who spotlights the people and places at the heart of our region.
Published April 19, 2026 5:00 AM
Long Beach is the latest SoCal city to get its own Monopoly game
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Top Trumps
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Topline:
A new Long Beach-themed Monopoly game turns local landmarks into playable spaces on the board. The game is part of a recent wave of city-specific editions that has the iconic game connecting with communities through nostalgia and local pride.
How to get a Monopoly game: To be featured, a city has to have enough people excited enough to support the production of thousands of games.
Why now: Top Trumps has expanded U.S. city editions in recent years as interest in board games has resurged after the pandemic. A company representative said that Long Beach, with its strong sense of community and recognizable landmarks, fit the model.
Monopoly lovers can now buy up the Queen Mary, collect rent on Belmont Shore and park their token at a storied tattoo shop, Outer Limits.
The Long Beach landmarks line the spaces of a new Monopoly edition themed around L.A. County’s second biggest city, released just this month.
The Long Beach edition is part of an expanding series of Monopoly games featuring dozens of American cities, which Hasbro licensee Top Trumps started to produce about five years ago when interest in board games surged during the pandemic.
What it takes to make the cut
How does a city land on one of the world's most popular board games? Turns out, it’s not just a roll of the dice.
“We’re looking for places with strong community pride, places where people will really love seeing their city on a Monopoly board,” said Jennifer Tripsea, a partnership sales executive with Top Trumps.
Long Beach fit the bill and got to join a list of SoCal cities on Monopoly boards including Huntington Beach, Riverside and Palm Springs.
Tripsea said in some instances, a city will pitch themselves to the company — she didn’t disclose which have — but not every place makes the cut.
There has to be enough population — or local enthusiasm — to support a run of thousands of games.
Top Trumps sells the games online and through local businesses, sometimes the same ones featured on the board. That creates a built-in customer base: residents, tourists and collectors hunting for their next addition.
And while some businesses may offer to sponsor their way into consideration, their inclusion isn’t a given.
Tripsea said when deciding who earns a spot, the company weighs cultural relevance, brand standards and community input.
The community gets a turn
Once a city is selected, residents are invited to help shape the board.
That means emailing suggested landmarks and drafting potential Chance and Community Chest cards. For Long Beach, one Community Chest card directs players to collect $100 if they "attend a beach cleanup at Alamitos Beach."
Hundreds of submissions flooded in over the last year, many pointing to the same top attractions, Tripsea said. The Queen Mary and Aquarium of the Pacific take up the same spots on the board that are occupied by Park Place and Boardwalk in the original game.
Of course the Queen Mary historic ocean liner landed a plum spot on the Long Beach version of Monopoly.
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Patrick T. Fallon
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Others featured on the board are lesser known to outsiders, like Rosie’s Dog Beach and the Arts Council for Long Beach.
The arts nonprofit was “surprised and excited” to hear from Top Trumps last year that they were being included in a version all about Long Beach, said interim executive director Lisa DeSmidt.
“I describe Long Beach as a big city that's run like a small town, and that everybody kind of knows each other to some degree,” DeSmidt said. “Long Beach has a sense of community in that Long Beach takes care of Long Beach people.”
An intern for the Arts Council for Long Beach designed its space on the Monopoly board.
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Arts Council for Long Beach
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An intern for the arts council, Peyton Smith, designed its space on the board, featuring small, intricate renderings of landmarks like the Long Beach Airport and the pyramid arena at Cal State Long Beach.
For DeSmidt, the game serves as a kind of cultural snapshot highlighting the city’s mix of arts, neighborhoods and institutions. It’s reminiscent of the council’s own project mapping the city’s cultural assets.
“This ties into uplifting what makes Long Beach unique and what people love about it,” DeSmidt said.
Monopoly's lasting pull
Outer Limits Tattoo was also invited to be part of the game, where it now appears next to VIP Records on the board.
Recognized as the country’s oldest continuously working tattoo shop, Outer Limits’ history dates back to 1927, when it opened in the waterfront amusement district known as The Pike, now home to the Pike Outlets.
Outer Limits' general manager Matt Hand said once word got out that the shop was stocking the game, customers started showing up just to buy it.
“It’s just a cool thing,” Hand said. “Especially when it’s like, ‘The business where I get tattooed’ is on the board.”
A big reason Hand thinks these editions are catching on is nostalgia. Seeing your own city in a board game that you played as a kid — and may be now playing with your own kids — is thrilling.
“You're basically like a part of the game now,” Hand said.
Keep up with LAist.
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29 migrants have died in ICE custody since October
By Sergio Martínez-Beltrán, Ximena Bustillo, Jasmine Garsd | NPR
Published April 18, 2026 1:13 PM
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Patrick T. Fallon
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NPR
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Topline:
The number of immigrants who have died while in Immigration and Customs Enforcement custody has reached an all-time high this fiscal year.
Where things stand: Twenty-nine people have died in ICE custody since October, the start of the federal government's fiscal year, already surpassing 2004's toll of 28, the previous record, according to government data. There are about 60,000 people currently in immigration detention.
Facilities in Texas and California are the deadliest: Adelanto ICE Processing Center in Adelanto, Calif., andCamp East Montana in El Paso, Texas have each reported the deaths of three detainees, the most out of ICE's sprawling detention operation.
The number of immigrants who have died while in Immigration and Customs Enforcement custody has reached an all-time high this fiscal year.
Twenty-nine people have died in ICE custody since October, the start of the federal government's fiscal year, already surpassing 2004's toll of 28, the previous record, according to government data.
The most recent death was of 27-year-old Aled Damien Carbonell-Betancourt, a Cuban man held in ICE custody in Miami. According to an initial report released by ICE on the evening of April 16, Carbonell-Betancourt was found unresponsive in his cell on the morning of April 12. The report lists the cause of death as a "presumed suicide," but the official cause remains under investigation.
The report said Carbonell-Betancourt entered the United States in 2024 without valid documents and later released into the U.S. via a program known as parole, which allows noncitizens to enter the country without a formal visa, often for humanitarian reasons.
He was arrested for resisting an officer with violence in 2025, and then transferred into ICE custody earlier this year, according to the ICE release.
The rise in deaths comes as detention numbers have skyrocketed during the Trump administration. Detentions are up more than 70% under President Donald Trump compared to the first year of the Biden administration. The Trump administration has carried out an unprecedented crackdown on immigration. Immigration officers have arrested and detained criminals in the country illegally, as well as many people without a criminal record and some migrants who are in the country with temporary protections from deportation.
In a statement to NPR, DHS denied there's been a spike in deaths and attributed the increase to the large number of people in detention. DHS said as of April 16, "death rates in custody under the Trump administration are 0.009% of the detained population."
The agency added that ICE provides migrants with access to medical care.
"For many illegal aliens this is the best healthcare they have received their entire lives," the statement said. The statement went on to encourage detainees to self-deport. "Being in detention is a choice. We encourage all illegal aliens to take control of their departure with the CBP Home App," the statement said.
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During a congressional hearing also on Thursday, acting ICE Director Todd Lyons said there are a high number of deaths this fiscal year "because we do have the highest amount in detention that ICE has ever had since its inception in 2003." Lyons added that the agency spent "almost half a billion dollars last fiscal year … to ensure that people have proper care."
He reiterated details noted by other DHS officials: that detainees get a complete physical within 14 days and are seen by a medical professional within 24 hours of being admitted.
"No death is what we want. We don't want anyone to die in custody," Lyons, who handed in his resignation hours after testifying, said. "I hope that's a policy of anyone that has to be tasked with detaining someone."
When asked how many people were still working in the Office of Detention Oversight, he was not able to provide a number.
Lyons was also asked about the delay in public reporting and tracking detainee deaths. On April 13, Georgia Democratic Sens. Jon Ossoff and Raphael Warnock sent a letter to Lyons and DHS Secretary Markwayne Mullin raising concern over the rising number of detainee deaths and noted that of the 49 deaths in custody at the time since January 2025, "ICE has issued an interim death notice within 48 hours in only 15 cases" and argued that reports contained less details.
"We are reporting. We are working on that timeline," Lyons said during the House hearing, agreeing that the detainee death reports were considered essential work even during the agency's funding lapse.
Facilities in Texas and California are the deadliest
One of the deaths at Camp East Montana was ruled a homicide by the El Paso County Medical Examiner's Office.
Initially, DHS said that Geraldo Lunas Campos had died in Camp East Montana after experiencing "medical distress." It also claimed Lunas Campos had become "disruptive while in line for medication" and was placed in segregation. But later, the El Paso Medical Examiner's Office ruled his death a homicide due to "asphyxia due to neck and torso compression." The FBI is now investigating the death.Chris Benoit, an attorney representing the family, told NPR Lunas Campos came to the U.S. in the mid-1990s as part of a wave of Cubans immigrants during the balsero crisis after the fall of the Soviet Union.
"For all sense and purposes he is an American," Benoit said. "He's lived here for decades and raised his family here and his kids love him and miss him."
According to DHS, Lunas Campos had been convicted of multiple crimes, including petty larceny, unlawful possession of a weapon during a robbery and sexual contact with a child under 11.
In a court petition seeking eyewitness testimony, Lunas Campos' three children said they planned to file a wrongful death lawsuit.
Rahul Mukherjee contributed to this report. Copyright 2026 NPR
This is a strain of Candida auris cultured in a petri dish at a laboratory at the Centers for Disease Control and Prevention. It's a form of yeast that can harm humans — and is resistant to the most common antifungal drugs.
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Shawn Lockhart
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AP
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Topline:
Combatting bacterial and viral infections is getting tougher because of their growing resistance to drugs. Antibiotic drugs can no longer be counted on to conquer nasty bacteria. Antivirals don't always overpower the viruses. This is a huge problem but it is one that widely acknowledged and researched.
Why it matters: Fungicides are used to protect plants against fungal disease. Everything — watermelons, maize, wheat, flowers — use lots of fungicides. If we didn't use the fungicides, you'd probably have a yield loss maybe of 30% or 40%.
The problem is that the fungicides are quite similar to the drugs we give to patients. So the fungus becomes resistant to the fungicide and, at the same time, our medical azoles [a class of antifungal drugs] do not work as well anymore.
Read on ... for more on the problem with fungicides and what can be done about them.
Combatting bacterial and viral infections is getting tougher because of their growing resistance to drugs. Antibiotic drugs can no longer be counted on to conquer nasty bacteria. Antivirals don't always overpower the viruses. This is a huge problem but it is one that widely acknowledged and researched.
There's an additional medical challenge though, that matters a lot. Namely, drug-resistant fungi.
Yep, fungi.
It's a topic that doesn't get discussed much — and that worries Paul Verweij, professor of clinical mycology at Radboud University Medical Center in Nijmegen, the Netherlands. He says there's a "silence surge" in drug-resistant fungi and that it's mostly happening under-the-radar.
This is a particular challenge in lower-income countries.
"Look at, for instance, Candida auris [a type of yeast that can cause severe infections and is often drug-resistant] -- you need very, very strict infection control measures in hospitals, you need good diagnostics, good infection control, you have to follow-up with patients and that's just not available in these lower- middle-income countries," he says. "People will die, and you won't know they have a fungal infection. You wouldn't know if it was resistant."
Verweij teamed up with 50 scientists around the world – from Brazil to Nigeria to China — to call for action against drug‑resistant fungi inNature Medicine this week.
NPR spoke with Verweij, who's been working on this issue for more than 20 years. His interview has been edited for length and clarity.
What's the link between agriculture and drug-resistant fungi?
Fungicides are used to protect plants against fungal disease. Everything — watermelons, maize, wheat, flowers — use lots of fungicides. If we didn't use the fungicides, you'd probably have a yield loss maybe of 30% or 40%.
The problem is that the fungicides are quite similar to the drugs we give to patients. So the fungus becomes resistant to the fungicide and, at the same time, our medical azoles [a class of antifungal drugs] do not work as well anymore.
The fungi which cause disease in humans are not causing disease in plants. So this is an unintended effect.
How does the resistance get from farms to hospitals?
So the molds – the hairy fungi – have spores which are released into the air. These spores travel long distances. It's not really well-understood but the idea is that they go right up to these jet streams, very high into the atmosphere and then can travel for continents. We inhale the spores all the time.
How serious are fungal infections?
With fungi you have two types of infections. First, we have very severe infections, and they usually occur in [hospitalized] patients who have some kind of defect in their immunity. So, yeast found in the bloodstream or mold in the lungs. Second, we have infections of the skin, the hair and the nails, which are irritating but are not life threatening.
In the past 10 to 20 years, we see more and more resistance in fungi in both those categories.
There are very few studies looking at the clinical impact. We did a study in the Netherlands, and we found that if you compare an infection [where azole antifungal drugs work] and where it's resistant. There's about a 20% difference in mortality — you're 20% more likely to die. So that's a significant impact. And there's the new skin disease [Trichophyton indotineae] where you don't have mortality but we've had patients who have been on treatment for four years and are still suffering from the infection.
Why is it hard to create new antifungals?
The main challenge is that fungi, if you look at the cell structure — how they are built up — it's very similar to the human cell. This is different from bacteria, because bacteria are much simpler. And viruses are even more simple because they don't even have a cell.
For fungi, because they're similar to human cells, it's quite difficult to find a drug which kills the fungus but does not harm the human cell. So in the past 75 years, we have developed only five classes of antifungals. The azoles are, by far, the most important.
The problem is that if you can't use one of these classes then maybe you'll have one alternative left. It's already causing problems. For instance, if the fungus is in the brain, you have a very few drugs which actually get into the brain.
What can be done?
At a mycology meeting we found a global community who wanted to collaborate [on this issue].
For example, you really want to know what people are using [on crops] and see if you can reduce that or if there's any unnecessary use. Another important factor is: If you introduce new fungicides, they [should] undergo an assessment to see their impact on human fungal pathogens. It's important to establish if there's a risk for cross resistance.
Are you optimistic?
I've worked in this field for a long time, and I think that it is changing.
WHO published a fungal pathogen list in 2022 for the first time — that had a major impact. A decade ago, when the World Health Organization came out with its global action plan against antimicrobial resistance, fungi were only mentioned twice. Now, after 10 years, it is being revised. And as a mycology community, we feel it is really important now that fungi are addressed.
The problem is, in fungi, we need to do the basic stuff: Develop the tools. Do the surveillance. Set up the [laboratory] networks. And it's sometimes difficult to get these basic things funded.
But overall, I think it's really changing. People are realizing this is not a local problem — it's really global.
