Two Dead, Four Seriously Ill After Aspergillus Infection Cluster at Sydney’s Royal Prince Alfred Hospital

Incident Overview

Two patients died and four others became seriously ill after contracting fungal infections at Sydney’s Royal Prince Alfred Hospital last year. Sydney Local Health District (SLHD) has confirmed it is investigating a cluster of infections caused by Aspergillus within the hospital’s transplant unit between October and December.

SLHD said six patients were confirmed to have been infected with Aspergillus during the cluster, with two deaths and four cases of serious illness. The infections occurred in the hospital’s transplant unit, where patients are often significantly immunocompromised and therefore at higher risk of severe outcomes.

Aspergillus is a mould found in soil, dust and damp environments, and is commonly associated with areas of high construction or demolition activity. SLHD acknowledged it is possible the cluster is linked to the hospital’s $940 million redevelopment, which has been underway since 2023.

Health Risks and Vulnerable Patients
SLHD said people can inhale Aspergillus spores daily without becoming unwell, but it can be significantly more harmful for immunocompromised patients, including those undergoing organ transplant procedures. Reported severe symptoms associated with serious Aspergillus infection include breathlessness, coughing up blood and respiratory failure.

Hospital Response and Ward Closure
SLHD said multiple actions began as soon as the issue was identified, led initially by infectious diseases clinicians. The transplant ward was closed while investigations and testing took place, with transplant patients relocated and potentially at-risk patients contacted.

“SLHD extends its deepest condolences to the families of the patients who died at Royal Prince Alfred Hospital and acknowledges the impact on all patients and families,” a spokesperson said.

Investigation and Safety Measures
SLHD confirmed the ward reopened earlier this month after a panel of experts — including NSW Chief Health Officer Kerry Chant — determined testing and analysis showed no ongoing harmful levels of Aspergillus.

The district said additional safety measures were implemented, including:

• a deep clean of the transplant ward
• review of air intake points
• upgrades to air filtration systems
• comprehensive air quality testing

SLHD said fungal infections remain a known risk for transplant patients, but the cluster required urgent investigation and escalation due to its severity.

In Summary

The infection cluster has raised fresh questions about environmental risks in major hospital redevelopment environments, particularly for transplant and other highly immunocompromised patients. SLHD says investigations remain ongoing, with safety upgrades and monitoring measures now in place following the ward’s reopening.