Explorer Levison Wood knows what it’s like to test your body to the limit. The former British Army captain has trekked alone through the Himalayas for a TV documentary, walked the 4,000-mile River Nile for nearly a year and even hitchhiked from the UK to India.
And during his nearly two decades of travel, the Staffordshire-born 40-year-old has also survived some of the world’s most deadly diseases – including malaria and dengue fever. These two mosquito-borne diseases together kill nearly 700,000 people worldwide every year.
But nothing had prepared him for the medical trauma he endured on a trip to Mexico earlier this year.
“I lay on the bed in my hotel room, gasping for breath, with a pounding heartbeat, chest pain and a temperature over 40C,” Levison says. “At one point I really thought I was going to die.”
The former British Army captain has trekked alone through the Himalayas for a TV documentary, hiked the 4,000-mile River Nile for nearly a year and even hitchhiked from the UK to India
The obvious culprit, he suspected, was Covid-19, which he had managed to avoid in the UK. A lateral flow test was indeed positive.
“So I locked myself in my hotel room for ten days in seclusion, hoping to just drive it out,” he says. “But instead of getting better, I got worse and worse.
“I remember thinking Covid turned out to be rougher than I expected. After the ten days were up, I still could barely get out of bed. But at this point I tested negative for Covid.”
But in addition to the coronavirus, Levison had also contracted a rare, potentially deadly fungal lung infection called histoplasmosis.
The fungus that causes it, Histoplasma capsulatum, is found in bird and bat droppings, which then contaminate the soil in the hot, humid areas where it is endemic.
Affected regions include the southern US, Central and South America and parts of Asia, Africa and Australia – all popular holiday destinations for Brits.
The danger comes when soil or droppings are disturbed – by gardening, farmers plowing fields, building, digging or people exploring caves inhabited by bats – and tiny mold spores become airborne and can be inhaled by anyone within a few feet. .
The spores travel deep into the airways and cause severe pneumonia, an infection that can be life-threatening without prompt treatment with high doses of intravenous antifungals. The first symptoms are flu-like and can range from fever and headache to a dry cough and fatigue.
But in addition to the coronavirus, Levison had also contracted a rare, potentially deadly fungal lung infection called histoplasmosis. The fungus that causes it, Histoplasma capsulatum, is found in bird and bat droppings, which then contaminate the soil in the hot, humid areas where it is endemic.
Without prompt treatment, the deadly spores can reach other major organs such as the liver, as well as the central nervous system, skin and brain.
Those at greatest risk are those with weaker immune systems, such as children under the age of two and people over 55, cancer patients undergoing chemotherapy, and patients taking potent steroids (such as drugs used to treat inflammatory bowel disease) or rheumatoid arthritis drugs that TNF inhibitors are called, which can also harm the body’s defense mechanisms.
But otherwise fit and healthy people, such as Levison, are not immune either. He had unknowingly inhaled mold spores while exploring bat-inhabited caves on the Yucatan Peninsula earlier in the New Year’s Eve break with friends.
One of the caves “was very hot and humid, and there were a lot of bats and droppings in a rather enclosed space,” he recalls.
“A few days later I got a mild fever and fatigue, so I thought I might have Covid.” But when he failed to recover, Levison gathered his strength to go to a local hospital. A chest X-ray showed he had pneumonia, which doctors attributed to Covid.
Their advice was that young, fit adults like him usually make a full recovery within 12 weeks with plenty of rest. “They told me not to exaggerate for a while to give my lungs a chance to recover.”
Aspergillosis is an infection caused by a fungus found in flower beds, compost, decaying leaves, and even bedding such as pillows over six months old. It can cause serious illness in anyone with lung disease or infections. A stock photo is used above
Levison would travel to Costa Rica a few days later to make a movie, and while there, his condition worsened. “I’ve had all kinds of infections and this was the worst of them all,” he says.
dr. Neil Stone, an infectious diseases and microbiology adviser at the NHS Foundation Trust of the University College London Hospitals, says: ‘In the UK we are likely to see around 30 to 40 severe cases per year of histoplasmosis requiring hospital treatment.
‘The fungus is not native to the UK, so it’s all infected travelers returning from abroad. But probably more cases here go undetected because doctors and patients in this country are not very familiar with them.’ He says visitors from parts of the US could be exposed to it. Not a built-up area like New York — “but if you visit rural areas of the Deep South, like Mississippi — you’re more likely to come into contact with it because it’s hot and humid there.”
He adds: ‘The problem is that most doctors in the UK have not encountered histoplasmosis before or are not familiar with it at all.’
Doctors may initially suspect Covid or give hospitalized patients intravenous antibiotics to combat what they mistakenly believe is bacterial pneumonia.
“I’ve heard of cases where the patient has shown no improvement after several weeks of IV antibiotics,” says Dr. Stone. ‘Only then will doctors finally realize that it may not be a bacterial infection but a fungus.’
Treatment in severe cases includes a 24-hour infusion of antifungals.
But an added complication is that the spores can lie dormant in the body for decades. Travelers may not realize they have come into contact with the fungus.
Some British soldiers who served in the tropics during World War II developed histoplasmosis more than 50 years later, when fungal particles lurking in their bodies came to life as their immune systems declined with age.
“Often people carry the fungus for years without any problems, until later in life they receive cancer treatment or something similar that suppresses their immune system,” says Dr. Stone. ‘That then activates the fungus again.’
While it’s too cold in the UK for the fungus to thrive here, that could change. In the past three years, the histoplasma fungus has reached Canada, which was once thought to be too cold for it.
“The geographic range for fungal diseases such as histoplasma is expanding,” says Dr. Stone.
He fears that if it comes here, Britain may be ill-prepared, as funding for research and development of drugs for fungal infections – including those found here, such as aspergillosis – will lag behind that for other infectious diseases.
Aspergillosis is an infection caused by a fungus found in flower beds, compost, decaying leaves, and even bedding such as pillows over six months old. It can cause serious illness in anyone with lung disease or infections.
Cryptococcosis, which is mainly spread by pigeon droppings and can cause potentially fatal meningitis in people with suppressed immune systems, is another fungal infection common here.
Less than 3 percent of infectious disease spending goes on fungal causes, Dr. Stone says.
“As a result, there are only three classes of antifungals available to treat serious fungal diseases, compared to dozens of classes of antibacterial therapies,” he adds.
It was when Levison’s blood oxygen level — which he measured with a pulse oximeter clipped onto the end of a finger — plummeted to 92 percent (less than 95 percent is considered dangerous), he rushed to a hospital in San Jose, where he had to pay £8,000 upfront for treatment.
“I just gave them my credit card and said, ‘Bring what you need or I’ll die of this’.”
While in the hospital, hooked up to oxygen, Levison contacted one of the friends who had been on the cave tour and returned to the UK. It turned out that he too was in hospital with the same symptoms, awaiting tests.
With a little online detective work, the pair came across references to histoplasmosis and begged their respective medical teams to run tests.
“When the results came back a few days later and confirmed it was what I had, I was shocked,” Levison says.
“They said my condition was so serious that if I left it for a few more days before seeking medical attention, I probably would have died.”
He was given an infusion of antifungal medication for five days and left the hospital after a week with antifungal tablets that he had to take daily for three months.
Nine months later, he has made a full recovery and even ventured into bat caves during a summer vacation to Borneo.
“I just tried to stay far away from them,” he says. “At least now I know there’s a yeast infection looming and I should seek urgent medical attention if I get any symptoms.”
The Art Of Exploration: Lessons In Curiosity, Leadership and Getting Things Done by Levison Wood is out now (Hodder & Stoughton).