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Mycopathologia (2011) 171:383386 DOI 10.1007/s11046-011-9428-4
Changing Epidemiology of Human MycosesChina and Beyond
S. S. Y. Wong K. Y. Yuen
Received: 6 April 2011 / Accepted: 6 April 2011 / Published online: 20 April 2011 Springer Science+Business Media B.V. 2011
Emerging and reemerging infectious diseases have shaped the landscape of medicine for the past three decades. Viral pathogens, especially those zoonotic in origin, have been in the centre of the limelight. It has been estimated that viruses and prions accounted for 43% of the 177 emerging and reemerging human pathogens up to 2005 [1]. Fungi are the minority this regard, as they made up only 12% of the pathogens in that survey.
Mycoses are frequently neglected as emerging and reemerging diseases. They do not normally cause explosive outbreaks, nor do they give rise to pandemics. Nevertheless, changes in the epidemiology of human mycoses have been taking place over the past decades, both in terms of the absolute numbers of patients affected and the diversity of pathogens involved. In this issue of Mycopathologia, Wu et al. described the epidemiology of human pathogenic fungi in China through three 10-yearly surveys (1986, 1996, 2006) in 39 centres in China (including Taiwan) [2]. The key ndings of the study include a decline in the number and proportion of dermatophytes among all the clinical isolates, and a rising prevalence of yeasts and other moulds being
recovered. The diversity of the species of fungi isolated also increased throughout the years.
A few considerations need to be taken in the interpretation of the data. While the change in the number of isolates could well be genuine, the population change during the study period has to be taken into account. The total population of China increased by almost 23% (an increase of over 244 million people) from 1986 to 2006 [3]. At the same time, the birth control policy of China results in a gradual change in the age structure of the population; in 1986, 70% of the population were aged 15 years and above, the gure rose to 79% in 2006 [3]. We are not totally certain whether the increase in numbers translate into increase in incidence of the infections. Secondly, does the increase in the number of species recovered represent improvements in...