Health care providers are urged to remain vigilant in recognizing and managing cases of highly contagious forms of ringworm and jock itch, which have been flagged as emerging public health concerns.
The CDC issued an alert noting that New York City reported multiple cases of TMVII between April and July 2024. This comes alongside findings from NYU Langone Health and the New York State Department of Health, underscoring the potential for increased cases and need for prompt diagnosis.
NYU Langone experts documented one of the first U.S. cases of a sexually transmitted fungal infection that can take months to treat. They also noted the largest U.S. cluster of patients with a similar therapy-resistant fungal strain. The CDC has advised health care providers to pay close attention to symptoms that could indicate TMVII, particularly in patients with recent travel history to Europe or Asia.
Both species, TMVII and Trichophyton indotineae (T. indotineae), cause tinea infections that affect the skin, spreading on the face, limbs, groin, and feet. The infections may resemble eczema rather than the typical circular ringworm lesions, which can delay accurate diagnosis and effective treatment.
Recent CDC Observations
The CDC’s Morbidity and Mortality Weekly Report provided additional context, highlighting the difficulties in treating TMVII and T. indotineae infections due to increasing resistance to standard antifungal therapies like terbinafine. While TMVII cases may respond to terbinafine, treatment can require prolonged therapy, sometimes spanning months. T. indotineae may respond to alternative antifungals like itraconazole, though this option carries risks due to potential drug interactions and side effects.
The CDC also stressed the importance of direct inquiries with patients regarding any rash or irritation around the groin or buttocks, especially for those who are sexually active, have recently traveled internationally, and present with itching in other body areas.
Transmission and Prevention
TMVII is primarily transmitted through close physical contact, including sexual transmission, and poses a risk of rapid spread in densely populated areas. The CDC advised that communal settings such as gyms and public showers could be additional risk sites, recommending health care providers inform patients about preventive measures, including avoiding shared personal items and promptly treating skin infections.
“These findings provide new insights into how some fungal skin infections from South Asia are adapting to evade our standard therapies,” said Dr. Avrom Caplan of NYU Langone Health. “Beyond recognizing these misleading signs, physicians must ensure treatment plans also address quality-of-life needs, given the challenging and prolonged nature of these infections.”
Dr. Caplan is collaborating with experts nationwide to expand research efforts and improve understanding of these evolving fungal threats.
Dermatologists and other health care providers should remain alert for signs of TMVII and T. indotineae infections, although overall U.S. rates are currently low.
