altGeneva----Each year, more than one million people who have been treated successfully for tuberculosis (TB) go on to develop a deadly fungal infection that is often left untreated because it is mistaken for a recurrence of TB.

A study published today in the Bulletin of the World Health Organization estimates that more than a million people develop chronic pulmonary aspergillosis after being treated for TB every year. Most cases occur in countries with high rates of TB including Bangladesh, China, India, Indonesia and the Philippines.

Aspergillus is an airborne fungus that everyone breathes in daily. It does not normally cause illness, except in people with a weakened immune system such as those with leukaemia, severe asthma, cystic fibrosis, HIV/AIDS and in people with damaged lungs such as those who have had TB.  Currently, around half those who do develop the disease die within five years.

The symptoms of chronic pulmonary aspergillosis – weight loss, severe shortness of breath, fatigue and coughing up blood – are so similar to those of TB that doctors often misdiagnose and prescribe the wrong treatment. The infection can grow undetected for years, by which time it is too late to treat successfully.

"Around one-third of TB patients develop cavities in their lungs, making them vulnerable to infection by the aspergillus fungus,"  says Dr David Denning of the National Aspergillosis Centre in England. “The study highlights the importance of following up on TB patients after their initial treatment, and having the right tests available."

Microbiological testing is needed to detect the disease early. It is usually treated using long-term antifungal medication and sometimes people need surgery. The earlier the diagnosis is made, the greater chance of survival.

The World Health Organization ( WHO) estimates there were about 8.8 million new cases of TB diagnosed in 2010. As more people survive TB, more attention is needed on their long-term health, including accurate – and early – diagnosis and treatment of pulmonary aspergillosis.

Read the paper here:

http://www.who.int/bulletin/volumes/89/12/11-089441.pdf


The Bulletin of the World Health Organization is one of the world’s leading public health journals. It is the flagship periodical of WHO, with a special focus on developing countries. Articles are peer-reviewed and are independent of WHO guidelines. Abstracts are now available in the six official languages of the United Nations.

Further items in this month's issue include:

The December issue table of contents can be found at: http://www.who.int/bulletin/volumes/89/12/en/index.html

The complete contents of the Bulletin, since 1948, is available free to all readers worldwide through PubMed Central, available at: http://www.pubmedcentral.nih.gov/tocrender.fcgi?journal=522&action=archive