Mold, Bacteria, Candida, and Virus Co-Infections

A “Blindspot” in the Medical Community, Mold Illness and Coinfections

Musings of an Old Compounding Pharmacist

“A person is walking down an empty street. Four thugs jump out and start beating him half to death. A policeman comes by, but only has one shot in his gun. The policeman shoots one of the thugs. Unfortunately, the person dies from the beating of the remaining three thugs.

Another day, a person is walking down the same empty street. Four thugs jump out and start beating him half to death. A policeman comes by, but only has two shot in his gun. He shoots two of the thugs. The person survives but spends six weeks in intensive care from the beating.

The following evening a person is walking down the same empty street. Four thugs from the same gang jump out and start beating him. A policeman arrives and shoots three of them. The person goes to the hospital for six days from the beating but survives.

The next night another person is walking down the same empty street. Four thugs from the same gang jump out. The person pulls out his own pistol, shoots all four of them and never has to go to the hospital. 

The four thugs represent the four main microbial pathogens: mold, bacteria, yeast, and viruses. That person is you!”

-Walter Hayhurst

Given the climate of a viral pandemic, I decided to search the literature on potential co-infections with other microbial infections.  A Co-infection is the simultaneous infection of a host by multiple pathogen species. Unfortunately, in virology, the literature is focused on the  simultaneous infection of a single cell by two or more virus particles.  I decided to learn more about common microbial co-infections and try to understand the impact mold can have when faced with mold sensitivity and co-infections with both bacteria and viruses.  Important Note: There is virtually no validated medical literature regarding the current pandemic; so I am focusing on other viruses to see what we can learn, which may or may not be of concern with the current pandemic.   I believe there may be some learning that can help mold sensitive individuals on safety precautions and what to look for so that any mold sensitivities are taken into consideration when seeking medical help.

The Current Challenges in the Medical Community

Co-infections with influenza are rarely diagnosed unless a patient is in serious condition or exhibits unknown symptoms in a hospital.  The main reason for this is that a physician usually stops testing when they receive a positive for a single strain of influenza.  Thus, if a patient test positive for Influenza A, they will not test for Influenza B since treatment is the same.

Lyme Disease

The problem we face with Lyme Disease, which has the most literature regarding co-infections, is the difficulty the medical community has in diagnosing the disease. In addition, the co-infections studied and documented are related to other rare tick born pathogens.

When looking at other similar epidemics or pandemics like SARS in 2003 (9.6% mortality) or the Swine Flu in 2009 (.02% mortality), the case numbers were small and disbursed widely so that there offers little chance to fully understand the pathology and epidemiology. The current climate will likely be the same.  Gaining an understanding and studying a disease while following strict regulatory and clinical design protocol is prohibitively expensive and virtually impossible to gather statistically valid data from which conclusions can be drawn.  Simply documenting cases is not accepted for drawing conclusions.  Studies require selection of patients with almost identical profiles, pre-testing of pathological parameters, and the accrual of patients.  Hospitals and the medical communities must take patients as they come during a crisis.  This is the unfortunate side of clinical studies.  Clinical studies require physicians to have very strict criteria regarding patient characteristics and often have trouble finding these patients.

Public Health and The Diagnosis of Fungal Infection

Fungal infections are not a common diagnosis unless they are obvious.  The CDC outlines the patients that are susceptible to fungal infections without acknowledging mold sensitivity or the impact of the environment on chronic diseases.  They outline:

• People living with HIV/AIDS
• Organ transplant patients
• Cancer patients
• Hospitalized patients
• Stem cell transplant patients
• People taking medications that weaken the immune system

For Fungal Outbreaks, the CDC defines them as when “two or more people get sick from contact with the same source, sometimes in the same time or place”.  When this happens, they have a branch that investigates. CDC’s Mycotic Diseases Branch works closely with federal, state, and local public health agencies and other partners. Together, they collect different types of data to find the source of the outbreak:

• Epidemiologic data to answer questions such as “Who got sick?” “When?” and “Where?”
• Patient samples such as blood or tissue are tested in a laboratory to find out which fungus is causing the illnesses.
• Environmental samples can help health officials determine if fungi in the environment match the patient samples, providing clues about where they might have gotten infected.

Unfortunately, the resources to investigate every water damaged home where the “ two or more people get sick” for communities or homes that are water damaged do not exist.  The burden lies with the patients.

CDC does provide limited information for Healthcare professionals, primarily focusing on common mold infections like candida and Aspergillus that have clear and obvious symptoms and diagnostics.  They do not address the pandemic of allergenic, pathogenic, and toxigenic molds that occur in water damaged & poorly ventilated buildings, or of storm destruction from communities hit by natural disasters.  In these situation, large populations are exposed to numerous dangerous molds that can impact human health.

Similar to today’s crises, Public Health has limited resources to address all of the needs of a community for an infectious outbreak.

Microbial Co-infections Understood Today

In the past few decades, few studies have focused narrowly on co-infections.  As a result, there are very few publications that investigate the physiology and pathology of co-infections and that are published in peer review journals.

The most obvious co-infections that have sufficient epidemiology data are HIV and Hepatitis viruses. Since HIV (discovered in early 1980s) evolves into AIDS which attacks the entire immune system and results in hospitalization.   Other serious infections, such as Hepatitis B &C, are screened and appear often as co-infections. About 40% of patients with HIV are co-infected with HCV.  For co-infection conditions, the symptoms and disease courses are usually more complex and serious than a single viral infection case. Although “super-infections” or co-infections can make the disease more severe and its progression faster, there is also the possibility that one of the agents, such as HCV, could help promote the clearings of the other virus, such as HBV, from the body. HCV could also take over the position of HBV and become the major virus to cause persistent chronic infection.

There are a Handful of Well-Recognized Co-infections

• Influenza is commonly co-infected with common bacteria, Streptococcus pneumoniaeand Staphylococcus aureus, which accounted for 35% (95% CI, 14%–56%) and 28% (95% CI, 16%–40%) respectively. During the Spanish Flu and Swine Flu, it is estimated that over 50% of patients died from secondary bacterial infections, even in hospital care.
• There are patients that are infected with both Influenza viruses, A&B.
• People can be co-infected with bothgonorrhea and syphilis. Those infections aren’t necessarily related to each other. Instead, they’re both related to similar types of activity.  In addition, it is not uncommon for the Herpes virus to coinfect these patients.
• Lyme disease is perhaps the most understood disease where the coinfection possibilities, such as Epstein Barr Virus, are well documented given physician’s ability to rule out coinfections during treatment. Lyme disease is also known to be continuously exacerbated by coinfection with mold.
• There have been clusters of death by an adenovirus where toxic mold was discovered in the dorms of university students.

Mold Illness and Co-infections

The most important element to keep in mind is that if you are mold sensitive, your immune system is likely active and compromised.  The active immune system can make a person more vulnerable to be infected by a virus and impact your body’s ability to fight the virus.  Alternatively, having a virus can make you more sensitive to mold and become more symptomatic.  There are some viral co-infections that are observed by physicians; however, there is little medical literature on the topic.  Co-infections with Cytomegaly, Lyme, Epstein Barr, Herpes, and other viruses seem to play a role in the chronic nature of mold illness.

Reducing Mold and Microbial Exposure at Home

If you are mold sensitive, reducing microbial levels in your living space may help support your overall well-being. A few practical steps can make a meaningful difference:

Fog or mist your home regularly.
Using a cold or hot fogger with a botanical antimicrobial solution can help reduce airborne and surface microbes in multiple areas of the home, including corners, crevices, cabinets, and drawers. Fogging is designed to reach many surfaces, though it is not a substitute for professional disinfection.

Clean surfaces and belongings.
Wiping down hard surfaces with a botanical mold treatment solution and washing clothing and bedding with an antifungal laundry detergent may help reduce microbial levels on items you contact daily.

These approaches are not designed to completely disinfect the home — they provide a non-toxic way to help manage mold, bacteria, and other microbes without harsh chemicals. You can check the EPA website for EPA-registered disinfectants if full disinfection is needed.

1. CDC website. Fungal Diseases. https://www.cdc.gov/fungal/
2. Klein, Eili, et. al. “The frequency of influenza and bacterial co-infection: a systematic review and meta‐analysis”. Influenza and other respiratory illnesses. June 24, 2016
3. Boske, Elizabeth PhD, MPH, CHES. The Difference Between Secondary Infection and Co-Infection
4. Holcombe, Madeline, “University of Maryland freshman dies from adenovirus-related illness” com.  November 21, 2018
5. Gregianini TS, et al.Journal of Infectious Diseases. 2019. Flu virus coinfection occurs more often than previously thought
6. Lymedisease.org