Fungal infections have gained wild attention thanks to the popularity of HBO's The Last of Us. The show depicts a fungal outbreak caused by the real-life zombie ant fungus Ophiocordyceps unilateralis. He imagines the outcome of society's collapse and a ruthless approach to protecting public health. But researchers in laboratories, hospitals and public health units around the world have for years warned of the rise of potentially ly fungal infections. With so few drugs and no vaccines on the horizon to treat major fungal infections, the potential harm caused by fungal infections has caused alarm at the highest levels of public health. I was part of a large international research team commissioned by the World Health Organization to understand which fungal pathogens we most need to study and which pose the greatest threat to public health. That's what his report found. The Last of Us: Fungal infections can really kill and are getting more and more dangerous Mushrooms are back on the agenda Before The Last of Us, many thought "mushroom" meant fungus or something moldy in a compost pile. If they thought of fungi regarding health, they thought of athlete's foot or toenail infections – familiar but not scary. However, fungi cause serious infections, especially in people with other health problems. People living with cancer, HIV or diabetes are particularly at risk for these infections, but it can also affect people who have had major surgery, stay in the intensive care unit, or have had another serious infection. This is because their immune systems are weakened or distracted, making room for "opportunistic infections." We've seen this in India, where black mold infections that have resulted in thousands of s complicate COVID cases. What is the fungal infection mucormycosis affecting COVID patients in India? It's a threat and it's getting more and more Long before The Last of Us, health officials had begun to notice serious fungal infections. In 2019, the US Centers for Disease Control identified the ly yeast Candida auris, which abruptly emerged in 2009, as an "immediate threat" due to its resistance to many known antifungal drugs. Explainer: What is Candida auris and who is at risk? A drug-resistant strain of Aspergillus fumigatus resulting from the overuse of antifungal chemicals in agriculture has entered the "watch" list. New and increasingly drug-resistant pathogens such as these are a public health challenge. Another is the increasing number of people at risk of contracting these infections. Rich countries offer more sophisticated healthcare than ever before, leaving more people vulnerable to serious fungal infections. Chemotherapy, organ transplants, major surgery, extra healthy years with diabetes offer opportunities for the fungus to take hold. While the risk factors in low-income settings differ, the numbers tell the same story – rates of serious fungal infections are increasing worldwide. Why does the CDC warn that antibiotic-resistant fungal infections are an immediate health threat? Then we worked with WHO. I was part of a large international team of researchers commissioned by WHO to analyze the last decade of research on fungal pathogens. To understand which pathogens need the most research and which pose the greatest public health threat, we conducted a worldwide survey of fungal disease experts. WHO published the results in a report published last year. They highlighted four critical priority pathogens: Candida auris, which is resistant to many antifungals and is a problem for vulnerable patients in hospitals Aspergillus fumigatus, which mainly affects the lungs. Infections can be fatal, even more so in the case of drug-resistant strains. Candida albicans, which can cause invasive infections in typically vulnerable patients Cryptococcus neoformans, which can infect the brain, especially in immunocompromised individuals. This is especially true in people with HIV where it is a leading killer. The WHO report calls for improvements in public health interventions, such as improved surveillance, a focus on research and development, and improved prophylaxis or infection prevention strategies. Viewers of The Last of Us will understand why these are so important. We need surveillance so we can know ahead of time where threats are coming from, otherwise we can't prepare. We need more research and development to develop vaccines and new treatments. So far we have not been able to develop any antifungal vaccines and have no way of producing and distributing one like we did for COVID. Despite the introduction of some new anti-fungals, the range is still very small and some fungal strains are resistant to all available drugs. Developing vaccines and drugs is difficult because fungal cells are human-like. Therefore, basic laboratory research is vital to identify ways to kill fungal cells without harming ourselves. Without giving any spoilers, it's safe to say that the public health interventions in The Last of Us are pretty extreme. Therefore, research on how to contain and contain fungal pathogens is also vital to avoiding such brutal and ineffective measures. Curious Kids: Are zombies real? Are fungal outbreaks possible? Mushroom frog plague, chytrid disease, killed countless amphibians. Researchers say it has caused the largest loss of biodiversity from a single disease ever recorded. Is a mushroom zombie apocalypse possible? Not for humans. The fungus in The Last of Us has evolved over thousands of years to infect a particular species of ant and affect its behavior. There is no realistic possibility for this organism to cross over to humans and control us. However, if we don't work hard to better understand fungi, we face very real threats to our health, biodiversity, and even food security. We can prevent a potential public health crisis by acting now.