---
title: A Third of Patients With Invasive Mold Disease Had None of the Risk Factors Doctors Look For
description: CDC researchers confirmed 449 cases of invasive mold disease at four Atlanta hospitals. A third of the patients had none of the usual risk factors.
author: Dr Marina Nani (Editor-in-Chief)
updated: 2026-08-11T09:18:12.371Z
canonical: https://richhealthmagazine.com/article/invasive-mold-disease-cdc-atlanta-risk-factors
image: https://cdn.nanimediahouse.com/invasive-mold-disease-cdc-136605.webp
categories: Longevity & Science
content_type: News
region: United States
publication: Rich Health Magazine
schema_type: Article
---

Most people breathe in mold spores without noticing and come to no harm. In a small number of people, almost all of them already seriously ill, the same spores start an infection in the lungs, the sinuses or the skin, and 45 percent of the patients in a new federal count were dead within 90 days.

The count is the first of its kind in the United States. Researchers at the Centers for Disease Control and Prevention went through laboratory records at four Atlanta hospitals covering five years and confirmed 449 cases of invasive mold disease. More than a third of those patients had none of the host risk factors that normally lead a doctor to suspect it.

## No One Was Required to Report These Infections

Invasive mold disease is not a nationally notifiable condition, so there is no national tally and a doctor who sees a case does not have to tell anyone. CDC researchers had previously put the burden at more than 15,000 hospitalizations a year in the United States, an estimate rather than a count.

To get closer to a count, the agency ran active laboratory surveillance through the Georgia Emerging Infections Program at three laboratories serving four Atlanta hospitals: two academic hospitals and their outpatient clinics, one federal hospital and one community hospital. Between 2020 and 2024 they identified 968 patients with a positive mold culture or a positive Aspergillus test, of whom 449 met the case criteria set by the National Institute of Allergy and Infectious Diseases Mycoses Study Group.

“It’s kind of the first time we’ve had an estimate like this,” said Dr. Jeremy Gold of the CDC, the study’s senior author. He said it is important to understand it now because the problem may grow, and pointed to a growing population of older adults who are more susceptible to these infections.

> "It’s kind of the first time we’ve had an estimate like this."
> — Dr. Jeremy Gold, CDC, senior author of the study

## A Third of the Confirmed Patients Had None of the Classic Risk Factors

Doctors are taught to think of invasive mold disease in a particular kind of patient: someone with recent neutropenia, a blood cancer, a transplant, or a course of immune-suppressing drugs. Among the 449 confirmed cases, 65 percent had at least one of those host factors and 53 percent had a clinical or imaging finding pointing to the disease. The other 35 percent had none of the host factors at all, and [the report’s authors wrote](https://europepmc.org/article/MED/42519973) that surveillance resting only on classic risk factors or typical findings could miss a substantial share of cases.

The lungs were the site of infection in 68 percent of cases. Aspergillus accounted for 71 percent of the confirmed infections, with Aspergillus fumigatus alone behind 21 percent.

## Nearly Half of the Patients Died Within Three Months

Among the cases from 2020 to 2023, 45 percent of patients had died of any cause within 90 days, 157 of 349. Forty-three percent had been in intensive care in the two weeks before their sample was taken, half needed a ventilator, and 81 percent were given an antifungal drug effective against molds.

The 58 patients who had [COVID-19](https://richhealthmagazine.com/article/severe-covid-reactivates-dormant-viruses-long-covid) at the time or shortly before did worse on both measures. Sixty-six percent of them had been in intensive care in the preceding two weeks, against 39 percent of the others, and 66 percent died within 90 days, against 41 percent. Both differences were statistically significant.

## The Numbers Give Hospitals a Benchmark, Not a National Picture

Gold said the study did not try to establish where any patient was first exposed, and that findings from the Atlanta area are hard to generalize to parts of the country where mold is more or less of a problem. What the numbers can do, he said, is give hospital administrators a rough sense of whether the cases they see fall in the expected range or point to an outbreak. At the two academic hospitals the average was 4.8 inpatient cases a year for every 100 inpatient beds; at the community hospital it was 2.8.

“I agree that the frequency of fungal infections will likely increase with climate change,” said Dr. Jeffrey Jenks, an infectious disease researcher at Duke University. Jenks called the findings valuable and said similar studies in other parts of the United States would help. Mold exposure is a recurring problem after hurricanes, floods and other natural disasters influenced by climate change.

## FAQ

**Q: Who is most likely to get invasive mold disease?**
People with weakened immune systems: recent neutropenia, a blood cancer, an organ or stem cell transplant, or certain immune-suppressing medications. Among the Atlanta cases, 43 percent of patients were aged 45 to 64 and 39 percent were 65 or older. Children accounted for less than 1 percent.

**Q: Is household mold the same thing as invasive mold disease?**
No. Most people inhale mold spores regularly and come to no harm. Spores can also enter the body through cuts or wounds, or from contaminated medical equipment. It is in people with weakened immune systems, including elderly people and cancer patients, that an exposure can become life-threatening.

**Q: Which molds cause these infections?**
Aspergillus was found in 71 percent of the Atlanta cases, most often Aspergillus fumigatus. Fusarium and the Mucorales group, which includes Mucor, Rhizomucor and Rhizopus, accounted for about 4 percent each, and Scedosporium for 3 percent. The infections can take hold in the lungs, the sinuses, the skin or the central nervous system.

**Q: Why are these infections not counted nationally?**
Invasive mold disease is not a nationally notifiable condition, so doctors are not required to report cases the way they must for some other infections. The Atlanta researchers reviewed laboratory records directly to work around that gap.