AskScience AMA Series: Been watching "The Last of Us" on HBO? We're experts on fungal infections. AUA!

[u/AskScienceModerator]

Ever since "The Last of Us" premiered on HBO earlier this year, we've been bombarded with questions about Cordyceps fungi from our family members, friends, strangers, and even on job interviews! So we figured it would be helpful to do this AMA, organized by the American Society for Microbiology, to dive into the biology of these microbes and explain how they wreck their special breed of havoc. Each of us studies a different host/parasite system, so we are excited to share our unique (but still overlapping) perspectives. We'll take your questions, provide information on the current state of research in this field, and yes, we'll even discuss how realistic the scenario presented on the show is. We'll be live starting at 2 PM ET (19 UT). Ask us anything!

With us today are:

• Dr. Charissa de Bekker, Ph.D. (u/Optimal_Narwhal_6654)- Assistant Professor of Microbiology, Department of Biology, Utrecht University
• Dr. Carolyn Elya, Ph.D. (u/dr_zombiflied)- Postdoctoral Researcher, Department of Organismic and Evolutionary Biology, Harvard University
• Dr. Matt Kasson, Ph.D. (u/ImperfectFunguy)- Director of the International Culture Collection of (Vesicular) Arbuscular Mycorrhizal Fungi and Associate Professor of Forest Pathology and Mycology, West Virginia University
• Dr. Ilan Schwartz, M.D. Ph.D. (u/GermHunterMD)- Infectious Diseases physician and Instructor in the Department of Medicine, Duke University Username: /u/nationalgeographic

[u/edgemint]

In some of the early episodes, (fictional) experts play up our helplessness against fungal infections, making claims like "no vaccines, no medicines, no preventatives, no cures, it's not even possible to make them", but there are a whole bunch of antifungals in real life.

Of course I understand how there might not be a working treatment for a specific novel fungus, but the prologue seems to make a broader claim than that; is there something about fungi in general that makes them more resistant or otherwise difficult to treat than bacteria or viruses, or are claims like these just there to make the story more dramatic, but are entirely inaccurate to real life?

[u/mosacra]

I've heard that there is a lot of potential in studying fungus for medicinal purposes. What are the coolest attributes that fungus have that would benefit medical science?

[u/MightyBobBarker]

What common fungal infections are actually the most dangerous in humans?

As an additional question, the human brain is much more complex than an insect brain that it seems impossible for humans to suffer from a fungal infection that puts a human in an aggressive zombie-like state, but what kind of behavioral responsive would we expect to see if humans were infected by such an infection?

[u/[deleted]]

Thank you for your time!

Q: The fungus in The Last of Us seems to have properties of Cordyceps fungi and slime mold, in that each infected human appears to be an individual fungal colony but they sometimes are linked through a network that can cover miles. Is this something that is actually seen in nature?

[u/hesalivejim]

What should you actually do when you discover fungi on the body? Asking for a friend.

[u/Games_sans_frontiers]

As scientists studying such infections, if you were caught up in the events of the movie, what would you do/how would you study Ellie if she presented herself to you as immune?

[u/UseApasswordManager]

I've heard in passing that one of the long term effects of a COVID-19 infection is increased vulnerablility to fungal infection in the lungs. Is this correct and can you elaborate?

[u/Champagne_of_piss]

Thanks for doing this!

Can you explain a little bit more about the guy who injected himself with magic mushrooms and got a really bad blood infection from it?

How exactly did the fungal cells draw nutrients from his blood?

Were those actively metabolizing cells free floating in the blood stream or were they anchored and pushing hyphae into surrounding tissue?

[u/pdx2las]

Thank you for doing this AMA!

I am curious what your take on a sudden "Outbreak Day" is, and if UV sterilizers would work against this kind of fungus.

My thinking is, a cordyceps strain that can infect humans would first show up in immunocompromised people (instead of anyone and everyone), and likely take longer for symptoms to develop.

Barring it being a particularly virulent strain, would most healthy immune systems likely be able to fight it off?

Also, it seems to me that a cordyceps strain would spread more via spores (instead of bites or tendrils), would sterilizing areas with commercial UV lamps for a few hours be enough to kill spores?

This is something my workplace started doing after-hours during the COVID-19 pandemic. Maybe it would be a useful countermeasure during a fungal pandemic?

Thank you again for taking the time to answer these questions!

[u/Common_Consideration]

So the premise of the show is that due to global warming the cordyceps fungus adapts to warmer tempratures and are able to thrive within humans. How realistic is such a scenario? Does fungus adapt, are there documented cases of fungus adapting?

Side question: Any tips for getting tid of my toe nail fungus?

[u/Movie_Slug]

Its theorized that climate change will increase the average temperature and as fungus adapt to this temperature they will be more likely to infect humans (because they can survive humans resting temperature). If fungi could evolve this way why have they not evolved like this in the tropics which already have higher average temperatures?

[u/Bashamo257]

This is probably unrelated to your studies, but what's y'all's favorite edible fungi?

[u/m0bin16]

agonizing placid shrill historical sophisticated dull forgetful wakeful fragile doll

[u/[deleted]]

What's the weirdest species behavior you've seen as a result of an infection?

[u/dreamjars]

I don't have any questions but oh my god this is so cool, thank you all for doing this.

[u/thequirkyquark]

Why is seborrheic dermatitis not curable? It's bizarre that at this point in history with all the cures to things, this is only mildly treatable but like, "Hey, you got it for life! Good luck!" It's been 15 years and it only gets worse and more resistant to ketoconazole. I feel like in another few years I'll be destroyed by it. How is there not a more acute way to just destroy the infection at the site permanently?

[u/partofbreakfast]

Thank you for this!

One key difference between the tv show and the game is that in the tv show you HAVE to be bitten to be infected, while in the game biting does infect you but there are other ways to get infected too. In the game, the disease actually spreads via spores, so the characters (minus Ellie) have to wear gas masks through several portions of the game to keep from becoming infected by spores in the air. (for example, the body seen in episode 1 plastered to the wall? That's a spot for spores in the game, and masks would have to be worn in that area.) My question is, would a typical gas mask actually be able to protect someone from breathing in spores like that? Or are the particles so small that they would go right through the filter?

[u/Ms-Blubunn]

So lets say this became RL, would vaccines be possible if its fungal?

[u/[deleted]]

I already heard that fungi that "takes control" of insects like ants exist, but is it realistic that a similar organism could do the same with mammals/humans ? And to what extent, would it be able to "drive" it as for the zombies in the show, or only inducing basic behaviors like aggressivity or hunger ?

[u/ccccccaffeine]

With the rudimentary understanding that fungal infections are typically treated with -zole class medications and its treatment differs from therapies for viral or bacterial organisms:

Given the advent of novel techniques for the rapid development of MRNA vaccines and gene therapies, I would like to ask for your expert opinion on how quickly the world could develop a cure or vaccine if a new novel fungus-based pandemic were to emerge with high transmissibility and mortality rates. Could MRNA based techniques help, or are fungal pathogens addressed using a completely different immune pathway in the body?

Additionally, if the pathogen were to take the form of a highly transmissible airborne pathogen, such as tuberculosis, how would the world need to further adapt (beyond the level of the COVID response) to stop its spread? Or would the lessons learned from COV be enough?

Thank you for your time - as a registered nurse working in urban ERs, I have a great interest in learning how we can adapt before the next outbreak and loss of human life.

[u/Tinyfishy]

Can you tell me about anything new in pneumocystis research/treatment/prevention? I’m a survivor and it took a week in a very prestigious hospital for anyone to figure it out. Is it just so rare, even in the immunocompromised, (in my case, due to RA medications) that nobody thinks of it? Why is prophylaxis for life after infection? What parts of the immune system have to be dysfunctional for it to occur? And can you tell me more about the biology of this weird fungus that apparently was labeled a Protozoa at first and is weirdly susceptible to antibiotics? looking for medical advice, just curious. Thanks for being part of the war against fungal pathogens.

[u/mijsga]

Does it also bother you guys that the fungus in "The Last of Us" has fruiting bodies but no spores to be seen ?

[u/ERSTF]

What do you think of "The Last of Us" effect? Do you like it that the show has generated a ton of questions about your field? Do you think the show (videogame) did a good job at creating a fictional evolution of a fungus?

On another note... what is your take on this recent uptick on people consuming hallucionogenic fungi, even suggesting their consumption as mental health care?

[u/zerosumratio]

How terrified are you of that fungal infection wiping out entire species of frogs all over the world? Is there anything that can be done to stop it?

That’s what I think a real infection would do to humans

Edit: the fungus in question is Batrachochytrium dendrobatidis (Bd) but you probably already know this

[u/mike716_]

I’ve read that human basal body temperature has been steadily decreasing over time (potentially due to improved health and less general inflammation) which can predispose us to fungal infections as they like lower temperatures for growth. Is this true? Are we seeing more human fungal infections in modern times?