Amidst the Covid-19 pandemic, India is facing another challenge in the form of mucormycosis or black fungus. Recently, Rajasthan declared its spread an epidemic as the number of cases spiked in the state. Doctors noticed a spike in queries related to the fungal infection, affecting patients who have recovered or recovering from Covid-19. While health care professionals and patients have to be extra cautious about the black fungus infection, it has to be noted that the disease is not contagious, which means it cannot spread from one person to another.
What is mucormycosis, and who is vulnerable to the infection?
According to the Centers for Disease Control and Prevention (CDC), it is a rare form of infection. It is more common among people who have health issues and are on medicines that can lower the strength of the immune system. There are certain groups of people who are more likely to get the infection, such as people suffering from diabetes, cancer, organ transplant, stem cell transplant, Neutropenia (lower number of white blood cells), corticosteroid users, drug addicts, and others.
How does infection enter the body?
The fungus can enter the patient’s body through contact with the fungal spores. It can enter in lungs or sinus if someone inhales the spores from the air. It can enter the skin through a burn, scrape, or other skin injuries.
Mucormycosis is not contagious
It has to be noted that mucormycosis is not contagious. It cannot spread between persons or persons and animals. CDC says, “Mucormycosis can’t spread between people or between people and animals”.
In a recent interview with Times Now, Dr. Akshay Nair, Oculoplastic Surgeon, Ocular Oncologist said that mucormycosis is not contagious. He said, “It is possible that a healthy person like you and me can have mucormycosis spores in our system, but unless an environment is created that allows mucormycosis to grow, which happens in diabetes, which happens in immuno-compromised people unless that happens, the disease will not be able to invade our system. It is only possible in those who are vulnerable.”
The onset of diabetes in Covid patients
One point that Dr. Akshay and several other experts have mentioned over the past few days that patients who were not diabetic before contracting diabetes now have diabetes. Some patients who were not even aware that they had diabetes are now vulnerable to mucormycosis after getting Covid. Mucormycosis is now being seen as the first sign of diabetes in such patients, said Dr. Akshay. “This is another group that we need to be alert about, and clinicians should tell the patient recovering from Covid that regardless of what your diabetic status was, you need to keep a watch on your blood sugar now.”
The uncontrolled use of steroids is causing higher blood sugar, says Dr. Ranganathan
Dr. Anand Ranganathan, who was also in the panel during the said discussion that, “The problem is, the more steroids you give, your blood glucose level also increase. So in effect you become “diabetic” even if you might not be and that is the problem, and I think conditions have to be absolutely strict because you need not be diabetic to get black fungus.”
He further added, “You can be a hale and hearty person and you are injected with steroids, and next thing you know not only your immunity goes down giving opportunity for this infection to hold but also your blood glucose increases and when it increases human receptor GPR increases which is a binder present on the black fungus. The more GPR is there, the more glucose is there, the more receptors would be there, and it would give black fungus an opportunity to hold.”
What do other experts say about Mucor
While talking to India today, Prof Sheetal Verma of microbiology at KGMU said, “Mucor is commonly found in soil, plants, decaying fruits and vegetables, and manure in the form of spores. The infection occurs in the sinus or lungs when someone breathes in these spores. But these spores are destroyed by the immune system in most cases. It happens very rarely to those with very low immunity.”
Dr. Anany Gupta, gastroenterology expert at AIIMS New Delhi, said, “Black fungus does not spread from animals to people. Those with low immunity for various reasons may get it. High steroids for a prolonged time also reduce immunity, making patients prone to such infections.”
What are the early signs of Black Fungus infection?
According to the guidelines for patients issued by AIIMS, here is a list of early signs of mucormycosis infection:
Headache and nasal obstruction even after taking pain medications
Nasal crusting and nasal discharge that could be brownish or tinged with blood
Loss of sensation or pain on the face
Discoloration of skin
Localized facial puffiness
In moderately advanced disease, eye/orbital mucor infection may occur. Some initial signs include:
Eye swelling or redness
Loss of vision
Pain in the eyes
What to do if you see signs of infection?
The first and foremost thing to do is to consult your doctor immediately. The doctor will examine you clinically and may take swabs from the nose and test for fungal infection. If the infection is strong, you may need treatment with antifungal medications and surgery.
Make sure to provide a complete history of diabetes to the doctor
Periodically get Sugar levels checked
Make sure to keep an eye on the early signs of Mucor
Maintain basic hygiene and cleanliness
Follow the advice of the doctor
Complete the course of treatment as suggested by the doctor
Do not Self medicate, especially steroids. Do not listen to any so-called experts who are sharing information on social media platforms. Take medicines only after consulting with a doctor
Do not delay reporting symptoms of Mucor
In any case, do not ignore medical advice. Do not skip medicine and do not indulge in anything that may compromise your immune system further