What is the deadly black fungus disease that threatens Corona recoverers in India

ArabiaWeather - On May 9, Ananya Mazumdar received a call that left her confused. Her panicked cousin explained that her 48-year-old aunt, who had recently recovered from the Coronavirus (COVID-19) infection, had lost most of her eyesight in both eyes.

Emergency room doctors at Max Super Specialty Hospital in Ghaziabad, a city in the Indian capital, New Delhi, suggested that due to the spread of infection, she needed immediate surgery to remove her eyes, and the family soon realized she had no other choice.

Anania Mazumdar, a diabetic aunt, was diagnosed with a very rare fungal infection called mucormycosis, which increases among recovering Corona patients and is colloquially referred to as " black fungi " due to its dark color. This deadly infection begins in the nose and spreads to the eyes and then the brain.

Public health experts blame the indiscriminate use of steroids to treat COVID-19 as the possible cause. Steroids reduce inflammation in the lungs. But the excessive use of these drugs in Covid-19 patients can lead to decreased immunity and raised blood sugar levels. These conditions make some patients, especially those with uncontrolled diabetes, vulnerable to such infections.

As India - the diabetes capital of the world - continues to fight the devastating second wave of Covid-19, otolaryngologists expect to see more cases of black fungus over the next few weeks.

In Delhi, for example, Manish Munjal, an ENT surgeon at Sir Ganga Ram Hospital, has treated nearly 15 new cases every day since last week. According to him, the city has recorded about 250 cases of fungal infection since April, and this is a large number compared to one or two cases he was treating each month before the pandemic.

In Maharashtra, western India, which has been hit hard by the Covid-19 virus, state health minister Rajesh Top said that there may be more than 2,000 people infected with the mucous fungus, and about 300 cases have been reported from four cities in the neighboring state of Gujarat, where the infection begins. Usually, the body becomes infected after two to three weeks of steroid treatment, and the country may see a spike in the numbers of cases in the coming weeks.

What is black fungus?

A mucous membrane fungus is an invasive infection caused by mucous fungi. These fungi are everywhere and are naturally found in our environment, often in soil. Humans become infected by inhaling fungal spores floating in the air and in dust. These germs settle in the nasal passages and sinuses and cause disease in this site.

But not everyone who has been exposed to the germs will become infected . "The development of fungal disease depends on a person's health status," says Tobias Hall, head of the infectious disease service at Memorial Sloan Kettering Cancer Center in New York. "For the majority of people with a normal immune system, no infection occurs."

As for people with weak immune systems, such as: those with leukemia and those undergoing chemotherapy or patients with bone marrow transplantation who are unable to form antibodies in the first weeks, they may fall victim to black fungus.

Likewise, during a COVID-19 infection, heavy and prolonged steroid doses can weaken the immune system, says Lancelot Pinto, a pulmonologist at PD Hinduja Hospital and Medical Research Center. "There is a misconception among doctors that the repercussions of Covid-19 infection are more serious, and that the necessary steroid dose be increased, which has not been supported by any experience so far."

Steroid can cause blood sugar levels to rise, which may present a particular challenge for patients with uncontrolled diabetes. Rising blood sugar levels and acidification of the blood create a fertile environment for the growth of Mucorales fungi.

Symptoms of black fungus infection

These fungi sprout to form long, tubular strands that can grow in the sinuses and extend into the bones and bloodstream.

Symptoms of mucositis (black fungus) and the development of infection may differ from person to person; They include throbbing headache, fever, pains in the face and nose, black nasal secretions, loss of vision, toothache, loosening of the teeth, swelling of the upper jaw, and sometimes facial paralysis.

If the infection is not treated, it can spread to the central nervous system, and this is more dangerous, as the risk of death exceeds 50% if the infection reaches the brain. But early diagnosis can be life-saving, but infection is extremely difficult to treat, even at an early stage.

Black fungus treatment

Patients are prescribed antifungal treatments such as amphotericin B lipid injections for at least 10 days to several weeks after diagnosis. But these essential medicines have the potential to cause significant side effects, including kidney damage.

Often, surgical intervention is also needed. In less severe cases, doctors insert an endoscope through the nasal cavity and remove any diseased tissue. If the infection spreads further, surgeons may need to remove the eyes or the jawbone.

Exacerbating the crisis in India and solutions to contain it

This unexpected disease has brought new challenges to patients physically, emotionally and financially suffering from the Coronavirus, and the increased demand for antifungal drugs has created severe shortages, leading to the emergence of a reverse market for drugs that were already too expensive for most people. And in India's overcrowded healthcare system, finding a place in a hospital can be another logistical nightmare.

While cases of mucous fungi in India appear in only a small fraction of the total number of COVID-19 cases in the country, the rise is alarming. To prevent such infections in the first place, public health experts stress that hospitals must maintain hygiene, especially for the devices that provide patients with oxygen. Doctors also advise prescribing steroid medications wisely and suggest regular monitoring of blood sugar levels for all Corona patients in hospital and at home, even in the post-recovery period.

Source: National Geographic