Resources
Barter, Devra M., et al. 2019. "Candida Bloodstream Infections Among Persons Who Inject Drugs—Denver Metropolitan Area, Colorado, 2017–
2018." Morbidity and Mortality Weekly Report 68, no. 12: 285–88. https://doi.org/10.15585/mmwr.mm6812a3.
Beach, Emily. 2018. "Fungus Vs. Mold." Sciencing. www.sciencing.com/fungus-vs-mold-5529716.html.
Centers for Disease Control and Prevention (CDC). 2018a. "Candida auris: A Drug-Resistant Germ That Spreads in Healthcare Facilities."
www.cdc.gov/fungal/candida-auris/c-auris-drug-resistant.html.
Centers for Disease Control and Prevention (CDC). 2018b. "Infection Prevention and Control for Candida auris. www.cdc.gov/fungal/
candida-auris/c-auris-infection-control.html.
Centers for Disease Control and Prevention (CDC). 2019a. "Aspergillosis." www.cdc.gov/fungal/diseases/aspergillosis/index.html.
Centers for Disease Control and Prevention (CDC). 2019b. "Tracking Candida auris." www.cdc.gov/fungal/candida-auris/tracking-c-auris.html.
Hassan, Mohamed I Abdelwahab, and Kerstin Voigt. 2019. "Pathogenicity Patterns of Mucormycosis: Epidemiology, Interaction with Immune Cells
and Virulence Factors." Medical Mycology 57, Suppl 2: S245–56. https://doi.org/10.1093/mmy/myz011.
Lesher, Jack L., Jr. "Tinea Corporis Treatment and Management: Medical Care, Surgical Care, Complications," 2018. https://emedicine.
medscape.com/article/1091473-treatment.
Mole, Beth. 2017. "We Inhale up to 10 Billion Mold Spores Daily; Here's Why You Haven't Died Yet." Ars Technica. www.arstechnica.com/
science/2017/09/moldy-mayhem-can-follow-fl oods-hurricanes-heres-why-you-likely-wont-die.
Richtel, Matt, and Andrew Jacobs. 2019. "A Mysterious Infection, Spanning the Globe in a Climate of Secrecy." New York Times, April 9, 2019, sec.
Health. www.nytimes.com/2019/04/06/health/drug-resistant-candida-auris.html.
Sam, Qi Hui, et al. 2017. "The Fungal Mycobiome and Its Interaction with Gut Bacteria in the Host." International Journal of Molecular Sciences 18,
no. 2. https://doi.org/10.3390/ijms18020330.
Seladi-Schulman, Jill. 2018. "Candida Albicans: Infections, Symptoms, and Treatments." Medical News Today. www.medicalnewstoday.com/
articles/322722.php.
Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 39
IMPLICATIONS FOR
MASSAGE THERAPY
Fungi are everywhere; they are virtually
unavoidable. This turns out to be a good
thing, since helpful fungi are key players in
healthy digestion and other physiological
functions. Even when they are out of
optimal balance, most fungal infections
are not threatening to fundamentally
healthy people. Internal infections of the
lungs or other organs indicate that the
person has compromised immune system
function, but in those circumstances,
the fungi are unlikely to be transmitted
directly from one person to another—they
are not directly contagious. This doesn't
preclude the transfer of fungal parasites
from surfaces, however. As we saw, this is
an important issue with Candida auris.
If a client has a diagnosed fungal
infection of the skin (such as a ringworm
lesion or athlete's foot), then we need to
observe basic precautions: we avoid the
lesion (which should be covered), and
we use standard hygienic practices to
safeguard ourselves and other clients. If
an infection is widespread and not clearly
localized, this may mean delaying an
appointment until treatment has been
successful. We must also take care not
to risk spreading a fungal infection from
one area of the body to another—this is
particularly relevant for athlete's foot.
Massage therapists who work in hospitals
or with very frail clients are likely to see
more extreme and potentially threatening
fungal infections than those who work in
other settings. These infections may involve
the lungs or other internal organs, and the
skin as well. In this situation, it is important
to be aware of what hygienic protocols
are being used for the patient—and to
communicate any observations about skin
health to the health-care team. The CDC
emphasizes the importance of excellent
hand hygiene in the context of working with
patients who may carry fungal infections.
We can't get away from fungi, nor do
we need to. But we do need to create an
environment that limits the risk of our
clients (or ourselves) going home with
new, unwelcome passengers. Fungi are yet
another reason to do a "hygiene audit" and
examine our standard practices for how we
manage our work environment. Do you
see any changes you want to make?
Ruth Werner is a former massage therapist,
a writer, and an NCBTMB-approved continuing
education provider. She wrote A Massage
Therapist's Guide to Pathology (available at
BooksofDiscovery.com), now in its sixth edition,
which is used in massage schools worldwide.
Werner is available at www.ruthwerner.com
or wernerworkshops@ruthwerner.com.
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