Season 2 of the successful series The Last of Us Removers spectators in a universe ravaged by an infection linked to a fungus that changes the behavior of humans it infects. Fiction gives the opportunity to question the fungal threat.
WHO establishes a catalog of 19 threatening mushrooms
Season 2 of the American series The Last of Us has been broadcast in France since April 2025. We find there the heroes of season 1 who evolve in the near future where the world we know no longer exists. A devastating epidemic – due to a fungus – transformed most of the earthlings into zombies and only a handful of survivors remain. If it is above all a fiction, the postapocalyptic scenario is not however devoid of a scientific background. While the attention of scientists has so far been mainly focused on bacteria and viruses, mushrooms may well constitute a new infectious threat – relatively passed under radars until today. This is evidenced by the list published recently by the World Health Organization. In 2022, the organization indeed established the very first list of priority fungal pathogens, ie “a catalog of the 19 mushrooms which represent the greatest threat to public health”, and this, in several titles.
First, they are becoming more and more common and resistant to treatments, “with only four classes of antifungal drugs currently available and few candidates under clinical development”, explains WHO. In addition, “for most fungal pathogens, there are no rapid and sensitive diagnostic tools, and those that exist are not easily available or affordable worldwide”.
The impact of global warming
Second, the invasive forms of fungal infections often affect seriously sick people who have serious underlying pathologies linked to the immune system. The people most exposed to invasive fungal infections are those which have cancer, HIV/AIDS, chronic respiratory disease or post-prime tuberculosis or who have undergone an organ transplant.
Finally, global warming increases the incidence and geographic scope of fungal diseases. For example, during the COVVI-19 pandemic, the reported incidence of invasive fungal infections increased significantly in hospitalized patients (also read the resistance to antifungal, unknown and increasingly disturbing).
Zombie behavior
However, the scenario of The Last of Us Should he challenge us? Probably. Already in 2023, season 1 had reacted scientists, like the PA PAULLY G. AUOWOEERERInfectiology specialist in Johns Hopkins Medicine Faculty (Baltimore, Maryland). In a video blog published on the website of Medscape.com – that we had translated – the American infectiousologist explained that the hypothesis of fungal propagation was reminiscent of a scientific article published in the very serious review JAMA . This study focused on the fungus Candida auris which caused an epidemic in Nevada in 2021, with mortality rates reaching up to 60 % and serious concerns about certain anti-fungal isolates. ” Although Candida auris Certainly does not cause zombie type behavior, he commented 2 years ago, I think that remains something very worrying. »»
However, is it credible to anticipate a pandemic similar to that described in the anticipation series on earth on earth The Last of Us In which the “cordycepts” fungus, which has transferred to global warming, infects humans who turn into cannibal creatures? Inserm asked the question to the mycologist Jean-Pierre GANGNEUX. For the head of the parasitology-mycology service of the Rennes University Hospital and Inserm researcher, if the fungus in question in the series, the “cordyceps”, does not contaminate humans, on the other hand, it is capable, in the nature of taking control of infected infected, which he uses to propagate their behavior “. Not reassuring.
Without going to the disaster scenario of The Last of Usthe fact remains that it is essential to be very interested in mushrooms, whether for their potential therapeutic benefits, as with the Psyl CARLOI, or their devastating power like that of Candida auris. Stimulating research and political interventions in order to strengthen the global response to fungal infections and resistance to antifungals, in a context of global warming is essential.
“We need more data and convincing elements on fungal infections and antifungal resistance in order to clarify and improve response to these priority pathogens »said, in 2022, the Dr Haileleyus GetahunDirector of the World Coordination Department of Antimicrobial Resistance to WHO. The main recommended measures are focused on the one hand, capacity building and monitoring of laboratories; On the other hand, support for investments in research, development and innovation (see box below) and finally, the improvement of public health interventions in terms of prevention and struggle. Symbol of its involvement on the subject, the WHO published its very first reports on diagnostic tests and the treatments for fungal infections this year.
So many considerations to take seriously so that reality does not go beyond fiction.
Treatments against fatal fungal infections: R&D in a standstill
Published in April of this year, the WHO report on antifungal drugs stresses that over the past 10 years, only four new antifungal drugs have been approved by the regulatory authorities of the United States of America, the European Union and China. Currently, nine antifungal drugs are under clinical development to be used against the most threatening mushrooms for health, as listed in the list of priority pathogens of the WHO. But only three of them are in phase 3, “which means that few approvals are expected over the next 10 years” comments the WHO.
If 22 candidate drugs are in preclinical development, this is “insufficient number to feed the clinical development sector taking into account the abandonment rates, risks and challenges associated with the first stages of development” considers WHO.
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