Undeniably, rashes suck. Not only for their near-constant itching and unsightly appearance, but because—like stomach aches and migranes—they fall into that amorphous category of symptoms that could be a sign of just about anything.
Is that new rash you have an allergic reaction? Inflammation? Did something bite you? Is it caused by bacteria? A virus? A fungus?
That last category of rash is particularly frustrating.
“Compared to viruses or bacteria, we don’t have a lot of tools to deal with fungal infections,” says Tom Carpino, an infectious disease epidemiologist who focuses on fungi. “There are no vaccines, treatments are poor and diagnostics are really challenging because it typically takes a long time for fungal infections to grow.”
Enter Trichophyton mentagrophytes genotype VII—more commonly referred to as TMVII, pronounced “T-M-seven.” It’s a type of fungal infection that’s been around for decades, but in recent years has generated clusters of infection among gay men in Europe and North America—most notably an outbreak of about 30 cases in Minnesota last year—spread primarily through sex between men.
It’s these clusters that are making Carpino, who worked with the U.S. Centers for Disease Control and Prevention on their mpox response, sit up and take notice.
“It’s finding the balance between making people informed and making them concerned,” he says. “We still have a lot of questions to answer about TMVII, but it has all the ingredients to become widespread.”
Though we don’t know everything, we do have enough information to educate and prepare men who have sex with men—who, as of right now, are the most likely to be infected. Like with all bacteria and viruses, fungi are living and changing. But here’s everything we know about TMVII today.
How does one get TMVII? What are its symptoms?
TMVII is spread through close skin-to-skin contact, as well as through shared items like towels or bedding. “It seems to be able to survive on surfaces for quite some time,” explains Carpino. Though the exact duration of TMVII’s survivability is still unknown, fungi in this family can survive on surfaces for more than a year. “And there can be many weeks or months between infection and when rashes start to appear.”
A TMVII rash isn’t pretty—it could be scaly or puss-filled, and will be painful and itchy. Rashes most commonly appear on or around the face, genitals or anus. In fact, that close association with sexual areas is why some are classifying TMVII as a new STI, even though you can get infected outside of a sexual context.
How do you test for or treat TMVII?
Perhaps TMVII’s most defining characteristic is its persistence. Unlike other fungal infections, like athlete’s foot, TMVII does not respond to topical creams or medications (that is, ones you rub into the rash).
This could pose an issue when it comes to treatment, especially because the infection is relatively new. Carpino is trying to get the word out about the fungus to gay communities, as doctors may not yet know about it and prescribe topical remedies, delaying effective treatment.
Even if doctors do prescribe an oral antifungal, if they don’t know it’s TMVII they likely won’t keep you on the medication for the proper length of time. For instance, clearing a ringworm fungal infection requires two to four weeks of oral medication. Carpino says getting rid of TMVII could take as long as 12 weeks. So knowing what kind of fungal infection you have is crucial. “And if you take the medication and then you stop, that can create anti-microbial resistance,” he says, potentially making it even harder to shake the infection.
Carpino says people who suspect they have TMVII should ask their doctors to collect a skin sample to send away for further testing.
Why are gay men getting TMVII?
The first reported case of TMVII in both the U.S. (2023) and Canada (2025) were among gay men who had travelled abroad and had sex with other men. The largest cluster so far has been the aforementioned outbreak in Minnesota last year.
It might be frustrating to hear of another infection disproportionately impacting gay men so soon after the 2022–23 mpox outbreak. But, in many ways, we are predisposed to such transmissions.
“We have sexual networks, often overlayed with air travel,” says Sean Hosein, the science and medicine editor at CATIE, an organization dedicated to sharing research and insights around HIV, hepatitis C and other STIs in Canada.
By sexual networks, Hosein refers to the patterns of gay men who attend global events—often designed around sex—and have sustained, close contact with a closed group of other participants. They then return home and once again have sustained, close contact with a group of local partners.
“So if something is happening within a group of gay men somewhere else, it’s likely to come here to Canada.”
As for the scale of TMVII here and abroad, it’s impossible to know right now, says Hosein. “It’s not being reported as widely as I think it should be, because that takes up time and doctors don’t get reimbursed for testing.” Nor has any public health agency yet classified TMVII as a reportable infection, meaning they’d start collecting and reporting infection numbers regionally, as with HIV or mpox.
Is TMVII dangerous? How do I prevent it?
Both Carpino and Hosein emphasize that, as of right now, no one has died or even been hospitalized due to TMVII. Unlike with mpox, there is no associated fever or chills. However, that doesn’t mean the infection should be ignored, or treatment delayed.
“There’s the whole equity issue of it impacting people living with HIV, or other folks who are immunocompromised,” says Carpino. As many learned during the COVID-19 pandemic, an unpleasant infection for one person can have severe consequences for someone whose immune system functions differently. In TMVII’s case, it could compound infections for those with weaker immune systems, opening the person up to further or more severe infections.
As well, the “seven” in TMVII refers to the genotype—with earlier versions of the fungus not as transmissible or persistent. But if you allow the fungus to live in your system for a while, or if you treat it ineffectively, that can create the conditions for TMVII to mutate into an even worse variant, says Carpino.
As for TMVII prevention, as mentioned earlier there is no vaccine for a fungus. Instead, Hosein recommends hygiene and self-diligence. “Wash your hands and body, and check to make sure you don’t have any cuts, bruises or skin abrasions, as those can all act as entry points for germs or fungi to get deeper into the skin.”
So is TMVII the new mpox?
Short answer: no, at least based on the information we have about TMVII right now.
“It’s certainly not having an impact like mpox did when that first appeared on the scene,” says Dr. Troy Grennan, physician lead at the BC Centre for Disease Control (BCCDC). In April 2022, Canada had only two confirmed mpox cases and by that July it had more than 530. “I’d done a TMVII temperature check about six months ago with folks in other cities in Canada, and as far as they were concerned, they weren’t seeing any of that spread.”
Yet in July 2026 the BCCDC still released guidance for providers to help doctors and other health professionals recognize and treat TMVII. However, Grennan says a bulletin like that shouldn’t necessarily be read as the fungus causing an inevitable outbreak.
“The only reason that document came out was because we were getting media requests about TMVII—we were not seeing the infections,” he says. The media read reports coming out of places like Minnesota and start asking about infection risk locally, even if there isn’t much.
As well, just as gay people may be predisposed for new infections if they engage in these global sexual networks, they’re also keen to stay on top of emerging health threats and solutions, says Grennan. That means more and more people might be talking about TMVII, but that doesn’t mean more people are getting it. “Members of the gay community are amongst the most health literate and proactive patients I see.”
