Is Black fungus really a new curse in this corona pandemic?
People are already frightened by the corona pandemic. The black fungus has added to the severity of the pandemic situation.
Living with coronavirus has been rigid. The hardship and struggles of human beings have increased by a new threat called Black Fungus. It is a new curse during this pandemic situation.
Indians have been the primary victims of this fungal infection. Though it is not a contagious disease like Covid-19, experts still warn about the severity of this infection. Any sort of carelessness regarding this disease can cause the death of the patient.
What is Black Fungus?
It is mainly a rare fungal infection also known as Mucormycosis. Though rare, it is considered a severe infection that causes vision problems like double or blurred vision, facial swelling, chest pain, fever, headache. Mucormycosis affects the sinuses and the brain, which results in a runny nose. Patients with a compromised immune system are at greater risk of being infected by this virus. SARS-CoV-2 infection and COVID-19 treatment make the immune system vulnerable to many bacterial and fungal infections like black fungus.
Black Fungus can't spread due to human or animal contact, but the fungal spores present in the air that we breathe act as a catalyst for the spread of this infection. It is transmitted by spores of molds- through the contaminated food, inhalation, or contamination of open wounds or cuts. These fungi usually do not affect people but are found in abundance in soils, decomposing organic matter (rotten fruit and vegetables), and animal manure.
It is not contagious and therefore does not transmit between people. Patients with the following factors are at greater risk of being infected: diabetes with high blood sugar levels, cancer, organ transplant, iron overload, kidney problems, long-term steroids.
Symptoms of Black Fungus
Symptoms of Mucormycosis mainly depend on the location of the infection. Infection begins in the mouth or nose and enters the central nervous system through the eyes.
If the fungal infection begins in the nose or sinus and extends to the brain, symptoms may include pain in one eye or headache and are followed by pain in the face, fever, loss of smell, numbness, a blocked or runny nose. It may seem that the person has sinusitis. The face of the person infected may look swollen on one side, with rapidly progressing "black lesions" near the nose or inside the mouth.
The person may suffer from vision problems due to the swelling of the eye, and vision may be blurred. When the lungs are infected, fever, chest pain, cough, or breathing difficulties can occur. In such conditions, blood coughing may also take place. Gastrointestinal tract infection may cause stomach aches, nausea, and even in some cases, bleeding occurs.
The skin may appear reddish due to tissue death. A very painful ulcer may be another symptom. Widespread mucormycosis typically occurs in people who are already sick from other medical conditions. That's why it can be hard to know which symptoms are related to mucormycosis. People with mucormycosis infection in the brain can develop changes mentally or even go to coma.
Cases of Black Fungus around the world
According to the BBC, around 12,000 cases of black fungus were reported in India. It is found in patients in the hospitals recovering from Covid-19. Even before covid-19, the mortality rate due to black fungus has been reported higher in this part of the world.
Patients who have recently recovered from covid-19 are falling prey to Mucormycosis. Diabetic patients also top this list. The common ground between them is that both classes of patients have a low immune system, ultimately getting infected by this fungal infection.
Around the globe, before the Covid pandemic, at least 38 countries had reported cases of mucormycosis. According to Leading International Fungal Education, India and Pakistan had the highest rates of around 140 cases per million every year. In Bangladesh, one confirmed occurrence of mucormycosis was detected. Doctors are awaiting test results for another suspected case.
Recently five cases of mucormycosis in weeks have been reported in Pakistan, and according to media reports, four had died as of May 12. Russia has also reported a few cases of mucormycosis in Covid patients recently - but the number of affected patients isn't detected yet. In Brazil, 29 cases so far have been reported. (Source: BBC)
Covid and the curse of Black Fungus
Not long ago, the world was free of covid. But now, every aspect of human life has been affected by the propagation of this life-threatening disease. The advent of Black Fungus has added up to our dilemma.
This illness is making another crucial health emergency in India during the COVID-19 pandemic. Doctors believe the use of steroids may be triggering mucormycosis, which has an overall mortality rate of 50%.
We know that Steroid is a life-saving treatment for severe and critically ill Covid-19 patients. Steroids reduce inflammation in the lungs of patients affected by COVID-19 and appear to help stop some of the damage that can happen when the body's immune system is thriving and struggling against coronavirus. But they also reduce immunity and push up blood sugar levels in Covid-19 patients, which is a risk factor.
This drop-in immunity in covid-19 patients could be triggering these cases of mucormycosis. As of May 2021, the Government of India reported that more than 11,700 people were receiving care for mucormycosis. Black Fungus became the name of infection in Indian media outlets due to the black discoloration of dead and dying tissue the fungus causes.
Even before the COVID-19 pandemic, India has been prone to mucormycosis, with rates estimated to be about 70 times higher than the rest of the world. Many Indian state governments saw its rapid growth and had to declare it an epidemic. In India, several cases of mucormycosis, aspergillosis, and candidiasis (also known as black, white, and yellow fungus) were reported in 2020-21. Reports show that these cases have a linkage to immunosuppressive treatment for COVID-19. As described previously, diabetes was the most common underlying medical condition. Most had been in hospital suffering from severe breathing problems due to COVID-19.
After recovery from COVID-19, mucormycosis develops 10-14 days later. The complications that develop due to infection are abnormal kidney, fungal infection in the sinus, brain, eyes, and gastrointestinal tract. In some, the disease was widespread all over the body. The diagnosis of mucormycosis was made at postmortem in two of the seven deaths. The authors began to question the use of steroids and immunosuppressive drugs as those three had no traditional risk factors before death.
The BBC news reported with the headline "Mucormycosis: The 'black fungus' maiming Covid patients in India" on the increased cases in India on May 21. Mucormycosis affecting the eyes occurs up to several weeks after recovery from COVID-19.
High rates of COVID infection and high rates of diabetes are the reasons for the remarkable presence of 'Black Fungus' in India. In May 2021, the Indian Council of Medical Research issued guidelines for recognizing and treating COVID-associated mucormycosis.
Is a black fungus pandemic on the rise?
Well, fortunately, the answer is no. Experts say Black Fungus may not take the form of a pandemic like COVID-19. The facts that support this statement are not ambiguous at all. Unlike COVID-19, mucormycosis can't spread due to contact. This alone reduces the chances of this fungal infection turning into a global epidemic. A report from Channel NewsAsia confirms this. Only a low immune system can cause this infection to affect some parts of our body like the sinus, brain, lungs, eyes, etc.
Diagnosis
A blood test can't confirm the diagnosis of Black Fungus. Diagnosis requires identifying the mold in the affected tissue by biopsy, which is the extraction of sample cells or tissue to determine the presence or extent of disease and confirming it with a fungal culture. Tests may also embrace the culture and direct the fungus in lung fluid, blood, serum, plasma, and urine. Blood tests contain a complete blood count to detect the fungus. Other blood tests include blood glucose, iron levels, bicarbonate, and electrolytes. Examination of the nasal passages may also be needed to determine any trace of fungus in the nasal cavity.
Possible routes of transmission
Today, medical news reports that poorly managed laundries in hospitals may be one of several ways of transmission of black fungus. Besides this, other possible sources of infection are adhesive bandages, wooden tongue depressors, and ostomy bags. The myths about person-to-person transmission going around the internet, face masks harboring black fungus, onions were the reasons behind the transmission, were all proven to be wrong.
Treatment
According to a report, Doctors in India are using Liposomal Amphotericin B for treating black fungus infections. To treat each person infected by mucormycosis, 20 doses of this injection are required. Doctors warn that one must watch out for the over-dosage of steroids as it may make people not immune to fungal infection.
Black fungus might not spread globally. But it still counts as a curse. If affected by the black fungus, the chances of survival are few. In this corona pandemic, the black fungus has become a major threat, especially to the Indians.
