Black fungus complication adds to India's Covid woes: All you need to know

NEW DELHI: The coronavirus has raised its 'ugly head' once again. With the pandemic raging with much greater intensity in India, deaths due to black fungus or mucormycosis in several parts of the country are also on the rise.

The government has told doctors to look out for signs of mucormycosis or 'black fungus' in Covid-19 patients as hospitals report a rise in cases of the rare but potentially fatal infection.

The Indian Council of Medical Research (ICMR) last week had said that doctors treating Covid-19 patients, diabetics and those with compromised immune systems should watch for early symptoms including sinus pain or nasal blockage on one side of the face, one-sided headache, swelling or numbness, toothache and loosening of teeth.

Why the spread of mucormycosis or black fungus is rising
Dr Mohan Nerkar, the director of Seven Star Hospital, said diabetic and other immunosuppressed patients are highly prone to fungal infections like mucormycosis.

“Many Covid patients had started taking medicines through self-treatment at homes with no monitoring or control of sugar. Some were also being advised by unqualified doctors, with medicines given without checking parameters, which is harmful. Some also resorted to home treatment remedies as per forwards on social media,” said Dr Nerkar.

“Many people also used oxygen cylinders at home with tap water in the flow meters, which may also have led to fungal infections like mucormycosis. Also, unhygienic lifestyle of living, and unclean ambience can also lead to health complications and attract diseases,” he said.



Dr V S Alagu Varshini, IAS, director, department of Ayush, Telangana state said that black fungi are very common and can be found on rotten vegetables mostly. "Mucormycosis is a very serious infection, but the good thing is that it is treatable and moreover preventable. With the adjourned treatment process, the patient's health progress can be much faster," she added.

States classify black fungus as an epidemic disease
Till now, cases of black fungus have been reported in various parts of the country including Karnataka, Uttarakhand, Telangana, Madhya Pradesh, Andhra Pradesh, Haryana and Bihar.

Among them, Andhra Pradesh, Rajasthan, Haryana, Telangana have classified black fungus as an epidemic disease.

Black fungus and death rate
Mucormycosis has a very high fatality rate and this has increased the woes of the health department which has deployed all its resources to combat Covid-19.

Mucormycosis was not a notified disease like malaria and hence its cases were not mapped and a database was not prepared, the official said.

Drugs used in the treatment of mucormycosis have severe side-effects, and can lead to kidney issues, neurological dysfunction and stroke, the doctor said.

Here's what you need to know about the Black fungus and its complications:
What is mucormycosis or black fungus
According to the Union health ministry, mucormycosis or black fungus is a complication caused by a fungal infection.

People catch mucormycosis by coming in contact with the fungal spores in the environment.

It can also develop on the skin after the fungus enters the skin through a cut, scrape, burn, or other type of skin trauma.

Who has more risk to black fungus
The health ministry said the disease is being detected among patients who are recovering or have recovered from Covid-19. Moreover, anyone who is diabetic and whose immune system is not functioning well needs to be on the guard against this.

The treatment
The treatment requires multidisciplinary expertise because the fungal infection spreads through the nose, eyes and can reach the brain.

Treatment involves surgically removing all dead and infected tissue. In some patients, this may result in loss of upper jaw or sometimes even the eye.

Cure may also involve a 4-6 weeks course of intravenous anti-fungal therapy. Since it affects various parts of the body, treatment requires a team of microbiologists, internal medicine specialists, intensivist neurologists, ENT specialists, ophthalmologists, dentists, surgeons and others.

Controlling diabetes is one of the foremost prevention methods suggested by ICMR. Hence, Covid-19 patients who are diabetic need to take utmost care.

Self-medication and over-dosage of steroids can result in fatal events and hence doctor’s prescription should be strictly followed.

Medicine used to treat black fungus cases
Amphotericin B Liposomal is being used for the treatment of the fungal infection.

Each infected patient would require 60 vials of the injection and each would cost about Rs 5,000-6,000.

Shortage of medicines to treat black fungus
The Delhi High Court on Wednesday asked the Centre and Delhi Government to apprise on the issue of shortage of medicine used for treating black fungus.

The high court said the government will have to elaborate what is the bottleneck and how the medicine can suddenly be in short supply when it is locally manufactured.

The issue of shortage of medicine Amphotericin B, for treating Mucormycosis (black fungus) was raised by advocate Rakesh Malhotra who also referred to a recent order passed by the Delhi government concerning requisitioning of the drug for the ailment.

WHO classifies Indian variant as one of global concern
The World Health Organization had said that the B.1.617 coronavirus variant first identified in India last year was being classified as a variant of global concern, with some preliminary studies showing that it spreads more easily.

One bright spot is that vaccines may be protective.

White House chief medical adviser Anthony Fauci said that preliminary evidence from lab studies suggest Covaxin, a vaccine developed in India, appears capable of neutralizing the variant.

(With inputs from agencies)

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