Epidemiology: surveillance of fungal infections

Surveillance for fungal diseases is essential to improve our understanding of their epidemiology and to enable research and prevention efforts to be p rioritized. In order to conduct better surveillance for fungal diseases, it is important to develop more accurate and timely diagnostic tests, to foll ow rigorous epidemiological methods and to have adequate support from publi c health agencies and the pharmaceutical industry. Investigations of nosoco mial and community outbreaks of fungal infection have also resulted in a be tter understanding of the sources and routes of transmission of these disea ses, and of the risk factors for infection. This has led to more effective prevention and control strategies. In addition, outbreak investigations hav e offered excellent opportunities to develop new molecular sub-typing metho ds, and to evaluate and validate older ones. For example, results obtained from a global epidemiological study of the genomic structure of Cryptococcu s neoformans have led to a better understanding of the epidemiology of cryp tococcosis. Similarly, a study of variations in the genotype of Trichophyto n rubrum has found that patients may become infected with multiple strains, which has important implications for study design when looking at the epid emiology of dermatophyte infections.