Amid the second wave of the Covid-19 pandemic, several states of India witnessed a rare fungal infection in a few COVID patients. This fungal infection has been declared as a reportable disease under the Epidemic Diseases Act, 1897. It is found to cause prolonged morbidity and mortality among Covid-19 patients.

“Mucormycosis or black fungus is an intrusive and invasive fungal infection caused by Mucorales mould”, explains Dr Laxman Jessani, Consultant, Infectious Diseases, Apollo Hospitals, Navi Mumbai. The common name ‘black fungus’ is in reference to the blackening that is caused by the disease.

It can affect various organs but currently manifests as invasive rhino-orbito-cerebral disease, affecting the ear, nose, throat, and mouth. It is non-contagious in nature but can cause a lot of damage internally and can be inoperable if not detected early.

It is more common among immunocompromised people whose immunity has curtailed due to Covid-19, diabetes, kidney disease, liver or cardiac disorders, age-related issues, or those on medication for auto-immune diseases like rheumatoid arthritis. 

Let us now talk about the early symptoms of Black Fungus and what one should watch out for?.

The disease germinates as a skin infection in the air pockets located behind the forehead, nose, cheekbones and in between the eyes and teeth. It then spreads to the eyes, lungs and can even spread to the brain. It leads to blackening or discolouration over the nose, blurred or double vision, chest pain, breathing difficulties and haemoptysis i.e., coughing of blood. The black colour is actually the dead tissue resulting from the fungal infection that invades the blood vessels and demolishes them causing tissue death.

Dr Jessani added, “The mould is naturally found in soil, air and even in the nasal passages and mucus of humans. However, it is governed by the body’s defence mechanisms that are weakened due to COVID”. 

Jiva Ayurveda Director Dr Partap Chauhan says,” Excessive use of steroids, uncontrolled blood sugar levels, unhygienic tubes used for oxygen supplies and poor nasal and oral care could be the reasons that lead to fungal infection. The use of untidy masks is also considered one of the causes of this fungal infection”

This disease has a mortality rate of 50% in case of treatment and over 90% in cases of non-treatment, claimed experts in accordance with available literature of disease.

Indian states like Odisha, Rajasthan, Madhya Pradesh, Gujarat, Bihar, Karnataka, Tamil Nadu and West Bengal were the first ones to spot the cases of this fatal infection.

On June 7’ 2021, Union Health Minister Dr Harsh Vardhan said that 28,252 cases of mucormycosis have so far been reported from 28 states/UTs in the country, of which 86 per cent cases have a history of COVID-19 and 62.3 percent of the infected beings were diabetic. Also, Maharashtra was found at the apex with the maximum number of Mucormycosis cases (6,339) followed by Gujarat (5,486).

MGM dean Dr Sanjay Dixit said, “The doctors have set up the treatment protocol amidst the shortage of the amphotericin B injection to control its spread. The patients are given a retrobulbar injection in the eye lobe to prevent it from spreading into the brain.”

The doctors are also giving oral antifungal drug-Posaconazole to patients instead of injections. These things have proved effective in the patients and giving wonderful results in critical situations, added Dr Dixit.

Patients, especially those with diabetes, those on immunosuppressants and steroids, or any condition that affects the immune system need to take precautions like controlling high blood sugar levels, monitoring blood sugar level regularly and using steroids and antifungal medicines only when prescribed by the doctor. 

Considering the strong and growing Covid-eye connection, people should begin using goggles and facial protection, while following other standard Covid appropriate behaviour and guidelines such as wearing masks, maintaining physical distancing, and frequent washing hands with soap.  Making no compromise on good food, stay hydrated, exercise regularly, have enough sleep, and cultivate a stress-free mind. In order to maintain good oral hygiene, gargle with 2 percent povidine iodine solution. To keep sinuses clear, steam inhalation is recommended. Nasal irrigation with betadine can help prevent infections. Avoiding dusty construction sites, and handling soil, moss, manure only with gloves. One must wear shoes, long trousers, and long-sleeved shirts while engaged in activities such as gardening. Maintaining personal hygiene through scrub baths is also useful.

Just by adhering to these guidelines, you may avoid crippling circumstances, after all, Prevention is always better than cure.