Explained: What is Mucormycosis or black fungus?
“Mucormycosis” or “Black Fungus” is a very rare infection, caused by exposure to mucor mould which is commonly found in soil, plant, manure, and decaying fruits and vegetable. Now one may ask why has this rare disease been on the highlight for the past couple of days.
India is experiencing a big spurt in cases of black fungus or Mucormycosis among those infected with or recovered from Covid-19 and is becoming a big reason for the medical community’s woes. Gujarat has reported the highest cases reaching up to 100, with Surat accounting for 40 cases in 15 days. 52 deaths were reported from Maharashtra with an estimated active case of around 2000.
Other states like Chhattisgarh, Odisha, Delhi and Madhya Pradesh, Rajasthan, and Telangana, too, have been reporting small yet active cases. With India already under crumbling pressure to cope with the current pandemic, the rising cases of Black fungus remain hugely concerning.
What is Black Fungus or Mucormycosis and which organs it affects?
Mucormycosis/ Black Fungus is a rare but serious fungal infection that is caused by a group of moulds called ‘Mucormycetes’. Mucormycetes or Black fungus live throughout the environment and is ubiquitous.
It affects areas from where it can be inhaled, mainly through the nose, sinus and lungs. If it enters from a wound or skin, then it can cause local infection, but if it enters from the sinus, it can affect the eyes and the brain. Poor control of diabetes is the biggest cause for the rising numbers, especially post-Covid.
Also, patients with immunocompromised systems, or those who have undergone a transplant, are on immunosuppressants, or have been on a ventilator for a long period, are at higher risk.
Dr Sweta Budyal, senior consultant endocrinologist, Fortis Hospital, Mulund explains that mucormycosis or Black Fungus frequently infects the sinuses, brain, or lungs. “While infection of the oral cavity or brain is the most common forms of mucormycosis, the fungus can also infect other areas of the body such as the gastrointestinal tract, skin, and other organ systems,” she says.
Doctors believe Black Fungus, with an overall mortality rate of 50% may also be triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients. The steroids that help reduce the inflammation in the lungs of a Covid-19 patient and stop some damage that can happen when the body’s immune system goes into overdrive to fight off coronavirus, also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients.
It is considered that this drop in immunity could be triggering these cases of Mucormycosis/ Black fungus.
Dr. Nair, who works in 3 hospitals in Mumbai said that” “Diabetes lowers the body’s immune defences, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire,” Around 40 of her patients are suffering from Mucormycosis/ Black fungus, many of whom were diabetics and had recovered from Covid-19 at home. 11 of them has to have an eye surgically removed.
Dr Raghuraj Hedge, an eye surgeon from Bangalore has a similar story to tell. He has witnessed 19 cases of Mucormycosis/ Black fungus to date, most of them young patients. With patients so sick that he couldn’t operate on them.
Symptoms of Mucormycosis or Black fungus-
When Mucor attacks the sinuses, it spreads to the lungs, the brain and the central nervous system. Common symptoms of the resulting Mucormycosis include
- Pain and redness around eyes and nose
- Shortness of breath
- Bloody or dark vomits
- Reddish and swollen skin near the nose or eyes.
- Facial pain
- Altered mental status
Doctors can diagnose it through a tissue biopsy and an X-ray scan of the lungs. But according to most of the doctors, their Patients arrive late, when they are already losing vision, and doctors have to surgically remove the eye to put a halt to the spreading of the infection.
In some cases, doctors in India say, patients, have lost their vision in both eyes. And in rare cases, doctors had to surgically remove the jaw bone to stop the disease from spreading.
An anti-fungal intravenous injection which costs 3,500 rupees a dose and has to be administered every day for up to eight weeks is the only drug effective against the disease.
Prevention for Mucormycosis or Black fungus
There are a few simple steps we can follow to lower our risk of contracting Mucormycosis/ Black Fungus.
- By making sure that Covid-19 patients – both in treatment and after recovery are being administered the right dose and duration of steroids.
- One should take care of the sugar levels after being discharged.
- Periodically sample the air in hospitals, especially in the critical care wards, to check for the presence of spores.
- Recovering patients should be advised to remain indoors until they regain their natural strength and immunity.
- It is also important for people with diabetes, Cancer kidney and liver diseases, and organ transplant patients, to keep a check on their glucose levels from time to time.
During these grim time, it becomes our duty and responsibility to adhere to all the rules and regulations set by the government for our and other’s safety. Therefore, stay home, stay safe and help fight against infection by staying indoors and taking all the required precaution.