Antifungal cleaning

In the UK, if you're trying to reduce fungal exposure in your home environment — especially important for those with CPA or ABPA — there are several effective antifungal cleaning solutions you can use safely and routinely.

Here’s a list of recommended antifungal solutions available or commonly used in the UK:

🧴 1. White Vinegar (Acetic Acid)

  • Effectiveness: Kills many types of mould, including Aspergillus.
  • How to use: Use neat (undiluted) on tiles, windowsills, bathroom surfaces. Leave for 30–60 mins, then scrub and rinse.
  • Pros: Natural, low-toxicity.

Caution: Not suitable on stone surfaces like marble or granite.

🧴 2. Hydrogen Peroxide (3–6%)

  • Effectiveness: Antifungal and antibacterial.
  • How to use: Spray on mould-affected areas. Leave 10–15 mins, scrub, then wipe clean.
  • Availability: Sold in chemists and online (e.g., Amazon UK).
  • Tip: Can bleach fabrics or surfaces — spot test first.

🧴 3. Borax (Sodium Borate)

  • Effectiveness: Inhibits fungal regrowth.
  • How to use: Mix 1 cup borax to 1 litre warm water. Apply with sponge or spray bottle.
  • Availability: Harder to find in shops, available online.
  • Caution: Keep away from children/pets; don’t ingest.

🧴 4. Specialist Mould Sprays (Commercial Products)
These are widely available in UK hardware stores (B&Q, Homebase, Screwfix) and supermarkets:

Brand Key Ingredient Notes
HG Mould Spray Benzalkonium chloride Strong, effective on black mould.
Astonish Mould & Mildew Blaster Sodium hypochlorite Bleach-based, powerful but with strong fumes.
Dettol Mould & Mildew Remover Sodium hypochlorite Good for bathroom tiles and grout.

💡 Note: While bleach can kill surface mould, it may not penetrate porous materials (like wood or plaster) deeply.

🧼 5. HEPA Filtered Vacuum + Antifungal Surface Wipes

  • Use a vacuum with HEPA filtration to reduce airborne spores.
  • Clean surfaces with fungal control wipes (some contain quaternary ammonium compounds***).

🔥 Do NOT Use:

  • Air fresheners or “mould foggers” not approved for respiratory-safe use.
  • DIY essential oil blends (like tea tree) unless confirmed safe — some oils can worsen respiratory irritation.

🛒 Where to Buy (UK):

  • Boots: Hydrogen peroxide, Dettol products.
  • Amazon UK: Borax, HG Mould Spray, vinegar in bulk.
  • B&Q, Wickes, Screwfix: Specialist mould removers.

 

*** Here's a deeper look at quaternary ammonium compounds (QACs) — often found in cleaning products marketed for killing mould, fungi, and bacteria — and their relevance for people with CPA or ABPA:

🧪 What Are Quaternary Ammonium Compounds (QACs)?

Quaternary ammonium compounds (often shortened to “quats”) are broad-spectrum disinfectants used in many household cleaners, hospital disinfectants, and antifungal sprays.

They’re especially effective against:

  • Fungal spores (including Aspergillus on surfaces),

  • Bacteria,

  • Viruses (enveloped types like coronaviruses),

  • And can inhibit regrowth of mould on treated surfaces.

🧼 Common QAC-Containing Products (UK)

Product Contains QACs Where Used
HG Mould Spray Benzalkonium chloride Bathroom tiles, windowsills.
Dettol Surface Cleanser (Clear spray) Benzalkonium chloride Kitchens, surfaces, bathrooms.
Zoflora (certain formulas) QACs + fragrance General cleaning (must be diluted).
Clinell Universal Wipes QACs + alcohol Hospital-grade surface wipes.

🟡 Note: Always check the label — not all Dettol or Zoflora products contain QACs.

💡 Why QACs Matter in CPA and ABPA Homes

  • CPA patients are at risk of colonisation or reinfection from Aspergillus spores, especially in damp, dusty, or unventilated environments.

  • ABPA patients can react allergically to spores, triggering flare-ups of wheezing, coughing, or chest tightness.

  • QACs are more effective than bleach at preventing fungal regrowth, especially on non-porous surfaces like plastic, glass, tiles, and sealed wood.

⚠️ Precautions When Using QACs

Although QACs are highly effective, they can be irritating to lungs and skin, particularly if:

  • The area is not well ventilated,

  • The product contains added fragrance (as with Zoflora),

  • Used in aerosol sprays (fine mist can be inhaled).

Tips for safer use:

  • Use gloves and open windows when cleaning.

  • Avoid spraying into the air; apply with a cloth instead.

  • Choose unscented, low-fragrance options (e.g., hospital-grade wipes or Dettol Surface Cleanser).

  • Do not mix with other products like vinegar or bleach — can release dangerous fumes.

✅ Safe-for-Lungs Options (with QACs)

If you or a loved one has ABPA or CPA, consider:

  • HG Mould Spray — effective and well-tolerated if room is ventilated.

  • Clinell Universal Wipes — used in NHS settings, fragrance-free versions available.

  • Dettol Surface Cleanser Spray (Clear bottle) — QAC-based, not bleach-based, less irritating.

by GAtherton

🌱 Safe Handling of Plants, Compost, and Soil for People with CPA

If you work with flowers, compost, mulch, or soil—as many people with CPA (chronic pulmonary aspergillosis) do—you’re regularly exposed to Aspergillus spores. Some of these may be resistant to antifungal medications, making workplace precautions even more important.

🧫 Why It's a Concern

  • Widespread Azole Fungicide Use: Agricultural fungicides share chemical similarities with medical antifungal drugs (like itraconazole and voriconazole), leading to resistant strains of Aspergillus fumigatus in the environment.

  • Environmental Reservoirs: Garden centres, compost heaps, potting sheds, and greenhouses can all harbor resistant spores.

  • Clinical Risk: If resistant spores are inhaled and cause infection, treatment becomes more difficult, requiring second-line drugs that may be less effective or more toxic.

✅ How You Can Protect Yourself While Staying on the Job

You don’t have to give up the work you love. With smart precautions and awareness, you can continue safely:

🛡️ Protect Yourself from Airborne Spores

  • Wear a certified FFP2, FFP3, or N95 mask (not a surgical or cloth mask).

  • Avoid opening compost bags or disturbing dry materials indoors.

  • Prioritise outdoor tasks or ensure good ventilation in work areas.

🧤 Glove Up and Gear Down

  • Use gloves when handling compost, soil, or mulch.

  • Change clothes after work and shower to remove spores from your skin and hair.

  • Keep work footwear separate from household shoes.

🧼 Wash Hands Frequently

  • Always wash your hands:

    • After handling compost, soil, or cut plants

    • After removing gloves or masks

    • Before eating or drinking

  • Use soap and warm water for at least 20 seconds. If unavailable, use hand sanitiser (minimum 60% alcohol).

🧼 Why Hand Hygiene Really Matters with CPA

Even though Aspergillus is primarily inhaled, clean hands help reduce accidental transfer of spores to your face, nose, and mouth. Here's why hand hygiene is especially important for people with CPA:

  • Reduces risk of transferring spores from contaminated surfaces or tools to your face.

  • Prevents secondary infections from viruses or bacteria, which are harder to fight with weakened lungs.

  • Supports immune safety if you’re taking antifungals, steroids, or immunosuppressants.

🔬 Stay on Top of Health Monitoring

  • Tell your respiratory team about your occupational exposure.

  • If your symptoms change or your antifungal treatment stops working, request resistance testing (not always automatic).

  • Keep up with routine blood tests, scans, and sputum cultures.

🌍 The Bigger Picture

Antifungal resistance in the environment is rising across the UK and Europe. Garden centres and plant-heavy environments are now recognised as higher-risk zones for people with CPA. But with protective equipment, hygiene routines, and regular monitoring, it's entirely possible to keep working safely—especially when your job brings purpose and joy.

by GAtherton

Food Rich, Nutrient Poor: Food Quality

Micronutrient Deficiency in the UK: What You Need to Know

Micronutrients — including vitamins and minerals such as vitamin D, iron, folate, vitamin B12, iodine, and magnesium — play a crucial role in maintaining good health. Yet, many people in the UK are unknowingly living with deficiencies that can affect energy, immune function, and long-term wellbeing.

This article offers clear guidance for the general UK population and includes specific notes for those with chronic respiratory conditions, such as aspergillosis.

Examples of processed foods

Understanding Micronutrient Deficiency in the UK

Prevalence: Micronutrient deficiency is more widespread than many assume:

  • Vitamin D: About 20% of UK adults are deficient, with up to 60% having suboptimal levels, especially during the winter months.
  • Iron: Nearly half of girls aged 11–18 and one in four women aged 19–64 have iron intakes below the Lower Reference Nutrient Intake.
  • Folate (Vitamin B9): Levels have dropped by 25–28% in recent years, with 89% of women of childbearing age below the threshold for neural tube defect prevention.
  • Vitamin B12: Around 6% of people under 60 and 20% of those over 60 are deficient.
  • Iodine: Affects about 21% of women of childbearing age.
  • Magnesium: Around 50% of women fall short of recommended intake levels.

Hospital Admissions: Cases of hospital admissions linked to micronutrient deficiency have tripled in the past decade, with over 800,000 reported in England and Wales last year.

Food Rich, Nutrient Poor: Although the UK has abundant access to food, modern dietary patterns often prioritise convenience over quality. Highly processed foods, which dominate many diets, are typically energy-dense but nutrient-poor. This means that while caloric intake may be sufficient—or even excessive—essential vitamins and minerals can still be lacking.

Common contributors include:

  • Overconsumption of refined carbohydrates, sugars, and fats.
  • Underconsumption of whole foods like fruits, vegetables, legumes, and whole grains.
  • Loss of nutrients during industrial food processing.
  • Soil depletion affecting nutrient content in produce.

This paradox—being food rich but nutrient poor—helps explain the persistence of deficiencies even in economically developed countries like the UK.

Signs and Symptoms to Watch For: Micronutrient deficiencies often develop gradually, and symptoms may be mistaken for other issues. Common signs include:

  • Vitamin D deficiency: Fatigue, muscle weakness, bone pain, frequent infections, low mood.
  • Iron deficiency: Tiredness, pale skin, shortness of breath, headaches, cold hands and feet, dizziness.
  • Folate deficiency: Fatigue, irritability, mouth sores, poor growth, cognitive issues.
  • Vitamin B12 deficiency: Pins and needles, tiredness, mouth ulcers, difficulty walking, memory problems.
  • Iodine deficiency: Swelling in the neck (goitre), fatigue, weight gain, sensitivity to cold, sluggish thinking.
  • Magnesium deficiency: Muscle cramps, tremors, nausea, poor appetite, abnormal heart rhythms.

Government & NHS Guidance

The UK government and NHS offer reliable, science-backed guidance:

  • NHS Vitamins and Minerals Portal provides information on sources, daily needs, and deficiency symptoms.
  • Eatwell Guide helps you structure a healthy diet visually.
  • SACN (Scientific Advisory Committee on Nutrition) publishes nutrient intake recommendations.
  • Healthy Start Scheme offers free supplements to low-income pregnant women and young children.

Key Nutrient Recommendations

  • Vitamin D: 10 micrograms (400 IU) daily, especially from October to March.
  • Iron: 14.8 mg daily for women aged 19–49; 8.7 mg for others.
  • Folate: 400 micrograms daily for women trying to conceive or pregnant.
  • Vitamin B12: Found in meat, dairy, and fortified foods; vegans and older adults may need supplements.
  • Iodine: Required for healthy thyroid and fetal brain development; found in dairy, seafood, and fortified products.
  • Magnesium: Present in nuts, whole grains, leafy greens; supplements may help if dietary intake is low.

Micronutrient Deficiencies in Men

While women and children are often highlighted in discussions about nutrient shortfalls, men in the UK are also at risk of micronutrient deficiencies. These can have serious effects on energy, immune health, cardiovascular function, and hormone balance.

Common issues in men include:

  • Vitamin D: Deficiency is common due to limited sun exposure. Affects bone health, mood, and immune function.
  • Magnesium: Often low in men with high stress levels, poor diets, or frequent alcohol intake. Symptoms include muscle cramps, fatigue, and heart irregularities.
  • Vitamin B12: Particularly affects older men due to reduced stomach acid. May cause memory problems, numbness, and fatigue.
  • Zinc: Important for testosterone production, immune health, and wound healing. Often low in men with poor diets or high alcohol consumption.
  • Selenium: Essential for sperm production and thyroid health. UK soil is low in selenium, contributing to overall low intake.
  • Iron: Though less common than in women, iron deficiency can affect men—especially due to gastrointestinal conditions, chronic illness, or vegetarian/vegan diets.

Men should be encouraged to eat a varied diet, monitor symptoms of deficiency, and consider blood tests if experiencing fatigue, mood changes, or unexplained physical symptoms.

Example of a balanced diet

Tips for the General Population

  • Balanced Diet: Focus on fruits, vegetables, whole grains, dairy or fortified alternatives, and lean protein.
  • Supplement Wisely: Consider supplements for vitamin D, iron, folate, and B12 if you're at risk.
  • Check Labels: Fortified foods can help meet requirements, especially for B12 and iodine.
  • Regular Health Checks: Blood tests can identify deficiencies early, particularly for at-risk groups.

Special Advice for People with Aspergillosis

Aspergillosis, especially chronic and allergic forms like CPA or ABPA, often affects individuals with compromised lung function and immune vulnerability. Micronutrient status plays a key role in immune resilience and respiratory health.

Important considerations:

  • Vitamin D: Has immunomodulatory properties and may reduce susceptibility to infections. Deficiency is common in those with chronic lung conditions.
  • Iron: Chronic inflammation can alter iron metabolism. Iron supplementation should be guided by lab results to avoid promoting fungal growth.
  • Magnesium & Vitamin B12: Long-term antifungal or corticosteroid use may impact absorption or levels.
  • Antioxidant Nutrients: A diet rich in vitamins A, C, and E may support lung tissue integrity.

Patients with aspergillosis should work closely with their healthcare team, including dietitians if available, to ensure optimal nutrient support as part of their long-term management plan.

Final Thoughts

Micronutrient deficiency is a growing but preventable concern in the UK. Simple actions like eating a varied diet, being aware of individual risk factors, and using targeted supplements can make a substantial difference. Those living with chronic respiratory illnesses, such as aspergillosis, should be particularly proactive in managing their nutritional status to help support better outcomes.

For more information, visit:

by GAtherton

Aspergilloma: Complete Patient Guidance

🦠 Aspergilloma: Complete Patient Guidance

📌 What Is an Aspergilloma?

An aspergilloma, or fungal ball, is a clump of Aspergillus fungus, mucus, and dead tissue that forms in a pre-existing cavity in the lungs. These cavities often result from conditions like:

  • Bronchiectasis

  • Tuberculosis (TB)

  • Emphysema

  • Sarcoidosis

The fungal ball is typically non-invasive, but it can still cause significant problems such as persistent coughing, airway obstruction, and especially hemoptysis (coughing up blood).

🔁 Which Comes First: Bronchiectasis or Aspergilloma?

This varies by patient:

  • In most cases, bronchiectasis develops first, creating abnormal airway spaces where Aspergillus can settle and grow.

  • In others, the presence of a fungal ball may worsen existing bronchiectasis through inflammation and mechanical irritation.

⚠️ Risks of Leaving Aspergilloma Untreated

If unmanaged, aspergillomas can cause:

1. Fungal Ball Growth

  • The ball can enlarge, worsening obstruction or symptoms.

2. Severe Bleeding

  • The ball can erode nearby blood vessels and lead to potentially fatal hemoptysis.

3. Worsening Lung Function

  • Chronic inflammation and local damage can lead to scarring and reduced breathing capacity.

4. Progression to Chronic Pulmonary Aspergillosis (CPA)

  • Over time, the infection can spread into surrounding lung tissue and evolve into CPA, which is harder to treat and more systemic.

⚕️ Treatment Options for Aspergilloma

✅ 1. Surgery (Lobectomy or Segmentectomy)

  • Surgery involves removing the cavity and fungal ball and is considered a definitive treatment, especially when:

    • There is severe or repeated bleeding

    • The fungal ball is enlarging

    • Lung function is still sufficient

Limitations:

  • Expensive and high-risk, especially in patients with poor lung function.

  • Post-surgical complications can include air leaks, infections, or respiratory failure.

🛑 Important: Fungal ball regrowth after surgery is possible, especially if underlying lung disease (like bronchiectasis or cavities from TB) remains. This happens in 5 - 15% of patients. Aspergillus can recolonize new or residual cavities, particularly if exposure to spores continues. Therefore, continued monitoring and preventive care are essential even after surgery.

⚠️ Non-Surgical Options (If Surgery Is Too Risky or Unaffordable)

1. Observation

  • For patients with no bleeding and stable imaging, regular monitoring is safe.

  • Includes imaging every 6–12 months and symptom review.

2. Oral Antifungal Therapy

  • Drugs like itraconazole, voriconazole, or posaconazole may help:

    • Reduce fungal burden

    • Minimize inflammation

    • Delay progression to CPA

  • They do not eliminate the fungal ball but may reduce symptoms or stop growth.

3. Embolization (BAE)

  • Used to control bleeding by blocking the feeding blood vessels.

  • Less invasive than surgery, but the bleeding may recur.

4. Inhaled Antifungals

  • Nebulized amphotericin B may reduce local fungal activity.

  • Used in some specialist centres for high-risk, inoperable patients.

🛡️ Supportive Management

For co-existing bronchiectasis and aspergilloma, supportive care is vital:

  • Continue mucus clearance (e.g. Fluimucil, chest physiotherapy)

  • Avoid dust, mold, compost, rotting vegetation, or ivy

  • Use FFP2/FFP3 masks during risky exposures

  • Get vaccinated (e.g., flu, pneumococcus, COVID-19)

  • Monitor for new or worsening symptoms

🧾 Summary Table of Aspergilloma Treatments

Option Removes Aspergilloma? Used When Cost/Risk
Surgery (resection) ✅ Yes Hemoptysis, large fungal ball High cost/risk
Antifungal meds ❌ No (but may help) Symptoms or growth risk Moderate
Observation only ❌ No No symptoms or stable Low
Embolization (BAE) ❌ No Bleeding emergency Moderate
Inhaled antifungals ❌ No (experimental) Adjunct or palliative Variable

🩺 Final Thoughts

  • Surgery is curative but not always an option—due to risk, cost, or lung function.

  • Fungal ball regrowth can occur, even after surgery, especially if cavities remain and exposure to spores continues.

  • Long-term monitoring, antifungal support, and environmental precautions are critical.

  • If you experience bleeding, sudden worsening cough, or weight loss, seek medical help immediately.

by GAtherton

Omalizumab: how does it help relieve ABPA?

Omalizumab (Xolair) is a monoclonal antibody that can significantly relieve symptoms in patients with Allergic Bronchopulmonary Aspergillosis (ABPA) by targeting the underlying allergic response.

Here’s how it works and why it helps:

🧬 Mechanism of Action

  • Omalizumab binds to free IgE antibodies in the blood.

  • This prevents IgE from attaching to immune cells (like mast cells and basophils), blocking the allergic cascade.

  • Over time, this leads to downregulation of IgE receptors, reducing immune hypersensitivity.

🩺 Benefits for Patients with ABPA

ABPA is driven by an IgE-mediated hypersensitivity to Aspergillus fumigatus, so omalizumab directly targets a key driver of the disease.

✅ Key Clinical Effects:

Effect How Omalizumab Helps
Reduces airway inflammation By calming the immune overreaction to Aspergillus
Improves asthma control Fewer exacerbations and better lung function
Lowers total IgE levels A marker of disease activity in ABPA
Reduces corticosteroid use Helps wean off oral steroids safely
Improves quality of life Less coughing, breathlessness, mucus plugging

📊 Who Responds Best?

  • Patients with uncontrolled ABPA despite steroids and antifungals

  • Those with frequent exacerbations or steroid dependency

  • Particularly helpful in patients with asthma + ABPA

⚠️ Notes

  • Omalizumab is given by injection every 2–4 weeks (dose based on weight and IgE levels).

  • It is not a cure for ABPA but can significantly reduce flare-ups and steroid need.

  • Not all patients respond — monitoring is essential.

by GAtherton

I'm frightened by the thought of visual disturbances if I take voriconazole

It's completely understandable to feel frightened about potential side effects like visual disturbances with voriconazole—especially if you've read about how common they can be. The good news is that while these effects are indeed reported, they're usually temporary, not harmful to the eyes, and tend to go away either within hours after a dose or over time as your body adjusts.

Here are some reassuring points:

  • Common but often mild: Around 30–40% of people report visual changes (like blurred vision, color changes, or brightness), but most describe them as minor and not distressing.

  • Usually short-lived: These effects often appear within 30–60 minutes after a dose and usually fade within a few hours.

  • Reversible: They're not linked to lasting damage and generally stop after discontinuing the drug.

  • Lower risk with lower doses or slow titration: If you're particularly sensitive or anxious, your doctor might be able to start with a lower dose or switch to a slower-release formulation (if available).

If you're at higher risk (e.g. already have eye issues, neurological concerns, or are taking interacting medications), this is worth discussing with your prescriber—sometimes a different antifungal like posaconazole or isavuconazole might be considered.

by GAtherton

Living with Aspergillosis: What You Don’t See

An invisible illness that changes everything.

What is Aspergillosis?

Aspergillosis is a long-term lung condition caused by a common mould (Aspergillus) found in the environment. For most people it’s harmless, but in some it causes serious illness, lung damage, and long-lasting symptoms. It can come in different forms such as:

  • Chronic Pulmonary Aspergillosis (CPA)
  • Allergic Bronchopulmonary Aspergillosis (ABPA)
  • Aspergilloma (fungal ball)

These are not contagious, but they are serious.

Why It's Hard to See

People with aspergillosis may look well but feel incredibly unwell. This condition is invisible but can cause:

  • Constant breathlessness
  • Severe fatigue
  • Chest pain or coughing (sometimes with blood)
  • Frequent infections
  • Side effects from long-term antifungal or steroid treatments

Patients may use walkers, oxygen, or mobility aids some days and not others. That doesn’t mean they are better or faking. This is a fluctuating illness.

"But You Look Fine..."

Looks can be deceiving. People with aspergillosis are often battling infection, inflammation, medication side effects, and mental strain every day.

Please don’t assume someone is well because they don’t look ill. If they cancel plans, rest more than others, or seem tired, it’s not laziness — it’s medical reality.

How You Can Support

  • Listen without judgement
  • Believe what they tell you about how they feel
  • Be flexible and patient
  • Offer practical help (shopping, transport, etc.)
  • Understand their limits can change daily

Final Words

Aspergillosis is an invisible disability. Your understanding makes an enormous difference. With the right support, people with this condition can live meaningful and dignified lives.

To learn more, visit: https://aspergillosis.org  https://www.aspergillosistrust.org/socialmedia

Thank you for taking the time to understand what you can’t always see.

by GAtherton

🟦 Key Patient Advice for Starting Voriconazole

When starting voriconazole for the first time, it's important to provide clear, practical, and safety-focused information. Here's what a patient should be told:

1. How to Take It:

  • Take voriconazole on an empty stomach — at least 1 hour before or 1 hour after food.

  • Take it exactly as prescribed — usually twice daily at regular times.

  • Don’t stop suddenly unless advised.

2. Common Side Effects to Watch For:

  • Visual disturbances (blurry vision, changes in color or brightness) — often early on and usually temporary.

  • Photosensitivity (sunburn easily) — wear sunscreen and protective clothing.

  • Nausea or upset stomach

  • Skin rashes — report any rash, as rare serious reactions can occur.

  • Liver irritation — signs include dark urine, yellowing of skin/eyes, or upper right abdominal pain.

3. Serious Side Effects – Report Immediately:

  • Visual symptoms that worsen or don’t go away

  • Severe rash or peeling skin

  • Confusion, hallucinations, or tremors

  • Signs of liver trouble (yellow eyes, dark urine, pale stools)

4. Blood Monitoring Needed:

  • Liver function tests (LFTs) are usually checked before treatment and regularly during treatment.

  • Blood levels of voriconazole may also be monitored, especially if:

    • You're not responding

    • Side effects occur

    • You're on other medications that interact

5. Medication Interactions:

Voriconazole interacts with many drugs including:

  • Steroids (may increase steroid levels)

  • Warfarin, statins, some diabetes medications

  • Proton pump inhibitors (like omeprazole)

  • Some heart or seizure drugs

Always tell your doctor or pharmacist about all medications and supplements.

6. Driving and Activities:

  • Avoid driving or operating machinery if you have visual symptoms or feel dizzy.

7. Alcohol and Grapefruit:

  • Avoid or limit alcohol, as it may increase side effects.

  • Avoid grapefruit — it can affect how voriconazole is processed.

by GAtherton

Could You Help Transform the Future of CPA Treatment?

Join the INCAS Trial at the National Aspergillosis Centre

If you’ve recently been diagnosed with chronic pulmonary aspergillosis (CPA) and are starting antifungal treatment, you may be eligible to take part in a pioneering clinical trial that could shape the future of care. If that is the case we will approach you to ask if you would like to join.

CPA is a long-term lung infection caused by the fungus Aspergillus, often in people with conditions like COPD or previous tuberculosis. It leads to progressive lung damage, frequent infections, and significant impact on quality of life. Current antifungal treatments help only about 60% of patients, and many face relapses, side effects, and long-term medication use.

The INCAS trial is testing whether adding a naturally occurring immune protein called interferon-gamma to standard antifungal therapy can lead to better outcomes — fewer infections, less lung damage, and improved day-to-day wellbeing. Interferon-gamma is already used safely in the NHS for other conditions, and early research at the National Aspergillosis Centre (NAC) has shown promising results for CPA.

What Is Involved?

If you choose to take part:

  • You’ll continue with standard antifungal treatment

  • You may be randomly assigned to receive interferon-gamma injections for 12 weeks (3 injections per week)

  • You’ll receive regular follow-up with chest scans, symptom tracking, and support from our expert team

All patients are closely monitored to ensure safety and comfort throughout the trial.

What Have Previous Participants Said?

Patients who took part in earlier studies shared their experiences with honesty and encouragement:

“They are missing a great opportunity… I certainly didn’t want to inject, but I need to be well, and this was a good chance at fewer infections and damping down the Aspergillus.”

“I only had one bad day — I phoned the NAC nurses, who reassured me it was expected and to carry on. Now, side effects are mild and usually gone by lunchtime. They don’t stop me like the chest problems used to.”

“I would really encourage patients to seize this chance of having gamma interferon.”

Others mentioned they were concerned at first about injections or travel, but found ways to manage:

“It doesn’t always hurt — yellow paediatric needles are the key, and a bit of tummy fat helps. Legs rarely hurt.”
“Travel’s harder now that my husband has trouble with his sight… but I understand the issue and can empathise.”

Is It Safe? What About Side Effects?

In our previous study, interferon-gamma was generally well tolerated. Some patients had mild flu-like symptoms after the injection, but these usually faded with time and were far less disruptive than a flare of CPA itself. Your care team will work closely with you and adjust support as needed.

This trial is all about learning more — not only about effectiveness, but also how easy and acceptable the treatment is for patients. The insights we gain will help shape a larger trial and may eventually transform the standard of care for CPA.

Why Take Part?

CPA affects around 3,600 people in the UK, with mortality as high as 40% within five years. If interferon-gamma proves successful, it could:

  • Shorten treatment durations

  • Reduce relapses

  • Improve quality of life for you and others

  • Open the door for better treatments in other chronic lung diseases too

You won’t just receive expert support from the UK’s leading CPA centre — you’ll help build the future of care.

“I wouldn’t be influenced by being paid. I’d be more concerned about safety and careful monitoring – which I got.”

🔗 Learn more at clinicaltrials.gov/NCT05653193 or speak to your team at the National Aspergillosis Centre.

You could be part of something that changes CPA care for good.

by GAtherton

Which types of medical practitioners can we rely on for illness in general, and why?

Which types of medical practitioners can we rely on for illness in general, and why? That’s a really smart way to think about navigating healthcare. Whether it’s a long-term condition, a mystery illness, or just keeping well, here’s a rundown of who can help, and what each brings to the table.

👩‍⚕️ 1. General Practitioner (GP) / Primary Care Doctor

Why:

  • Your first point of contact.

  • Coordinates your overall care.

  • Knows your history, medications, and context.

  • Can spot red flags, order initial tests, and refer you to specialists.

Trust for:

  • Ongoing care, prescriptions, chronic illness monitoring.

  • Referrals to appropriate specialists.

  • Managing multiple conditions together.

🏥 2. Specialist Consultants

Why:

  • Deep expertise in a particular system or illness (e.g., lungs, heart, kidneys, neurology, skin).

  • Offer diagnosis, long-term management, and access to newer treatments.

Types to know:

  • Respiratory Physician – lungs, asthma, COPD, infections, ABPA, CPA, etc.

  • Cardiologist – heart issues, blood pressure, rhythm problems.

  • Neurologist – brain and nervous system.

  • Nephrologist – kidneys.

  • Gastroenterologist – digestive system.

  • Rheumatologist – autoimmune and inflammatory disease.

  • Endocrinologist – hormones, diabetes, thyroid, adrenal glands.

  • Dermatologist – skin, rashes, allergy-related problems.

  • Haematologist – blood disorders.

  • Infectious Disease – complex infections, immune-related infections.

🧠 3. Psychologist / Psychiatrist

Why:

  • Health isn't just physical. Chronic illness can bring anxiety, depression, fatigue, trauma.

  • Psychologists support coping, adjustment, and therapy.

  • Psychiatrists focus on medical treatment for mental health.

💉 4. Pharmacist

Why:

  • Medication experts.

  • Can advise on side effects, drug interactions, and how to take meds safely.

  • Some can do blood pressure checks, minor illness prescribing, and reviews.

🧪 5. Specialist Nurses

Why:

  • Often work alongside consultants (e.g., asthma nurse, diabetes nurse).

  • Provide detailed care, education, and monitoring.

  • Easier to access and often more time to talk through things.

🧬 6. Clinical Immunologist / Allergist

Why:

  • Especially useful in undiagnosed illnesses, fatigue syndromes, immune dysfunction, unusual infections, or multiple sensitivities.

🧘‍♀️ 7. Allied Health Professionals

  • Physiotherapists – recovery, mobility, lung clearance, joint problems.

  • Occupational Therapists – daily living support, adaptations, fatigue pacing.

  • Dietitians – nutrition support for chronic conditions or allergies.

  • Speech & Language Therapists – voice, swallowing, and breathing coordination.

💻 8. Specialist Centres / Multidisciplinary Teams

Why:

  • Some conditions need a joined-up approach. These centres pool multiple experts in one team.

  • Great for rare, chronic, or complex conditions like autoimmune disease, rare infections, or multisystem illness.

🔎 Bonus: Second Opinions

Sometimes, even the best doctors don’t have all the answers. Getting a second opinion—especially from someone in a specialist centre—can unlock progress or new treatment options.

Why We Rely on Medically Trained Practitioners

Medically trained practitioners—such as doctors, nurses, physiotherapists, and pharmacists—are trusted because they follow science-based training, clinical guidelines, and ethical standards. They:

  • Use evidence to guide decisions
  • Are trained to diagnose and treat a wide range of health conditions
  • Understand the interactions and risks of different treatments
  • Are accountable to professional regulatory bodies

When choosing someone to support your care, it's important to make sure they are registered with a professional body, which means they are properly trained, regulated, and insured.

Here are examples of registered professional groups in the UK:

  • GMC – General Medical Council (doctors)
  • NMC – Nursing and Midwifery Council (nurses, midwives)
  • HCPC – Health and Care Professions Council (physiotherapists, dietitians, paramedics, and others)
  • GPhC – General Pharmaceutical Council (pharmacists)
  • CNHC – Complementary and Natural Healthcare Council (some complementary therapists)
  • BAcC – British Acupuncture Council (acupuncturists)
  • GOsC – General Osteopathic Council (osteopaths)
  • GCC – General Chiropractic Council (chiropractors)

Choosing someone from these groups helps ensure you receive safe, professional, and accountable care.

  1. Always tell your doctor or nurse about any therapies, supplements, or herbal products you're using.
  2. Don’t stop prescribed treatments unless your doctor agrees.
  3. Choose qualified practitioners who are registered with a professional body (like CNHC, BAcC, or HCPC).
  4. Start slowly and track your symptoms.
  5. Use trusted sources for health information (NHS, hospital websites, academic studies).

by GAtherton