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OP-ED: How worried should we be about black fungus?

Mucormycosis is rare, but treatment is rather expensive

Update : 28 May 2021, 03:26 AM

Rare infections such as black fungus (mucormycosis), white fungus (candidiasis), and yellow fungus have emerged as secondary diseases in persons who recovered from Covid-19, and specialists believe this is due to an overuse of immune-suppressing medicines during the Covid-19 pandemic.

According to official sources, a Bangladeshi hospital in the capital Dhaka has found two cases of black fungus, which has been labelled an epidemic in neighbouring India. Unfortunately for Bangladesh, the possibility of an outbreak has spread to the country as a result of an increase in its neighbouring country, India. There have been reports of black fungus being present in a few Covid-19 infected patients.

Although the second coronavirus wave is finally showing signs of abating, with new daily cases in India at their lowest level since mid-April, new fungal illnesses have emerged in its wake, including the fatal “black fungus” and “yellow fungus.”

Mucormycosis has been found in people who have tested positive for Covid-19 or who have recovered from it. Patients with kidney failure, heart disease, or liver disease are also more susceptible to get an infection. Mucormycetes, which are already present in our surroundings, cause both black and white fungus.

Yellow fungus, also known as mucor septic, is a fungal infection that, according to specialists, primarily affects lizards rather than people. Covid-19 treatment includes steroids and immune-suppressants, which leave the body with weakened immunity. It affects the lungs and, in some cases, can also lead to an allergic reaction. 

According to the Centres for Disease Control and Prevention, mucormycosis has a 54% fatality rate, which varies depending on the patient’s condition and the body area affected. It affects the sinuses, the brain, and the lungs, and it can be fatal in people with diabetes or those with highly impaired immune systems, such as cancer patients or individuals with HIV/AIDS.

In India, more than 10,000 cases of black fungus have been detected thus far. In severe cases, the fungus affects the eyes, nose, face, lungs, and even the brain. According to experts, the surge in black fungus cases may be due to the usage of steroids. People who have been administered steroids for an extended period of time, have other comorbidities, or are on oxygen support for an extended period of time are more likely to get the illness. It can be lethal if not treated promptly as reported by The Guardian.

When someone with weakened immunity breathes in the fungal spores existing in the environment, the pathogens infiltrate their respiratory system and impact their sinuses or lungs, as is common in all such fungal cases. Because the second wave of Covid is more contagious than the first, most victims have been administered steroids. This reduces the patient’s immunity, making the patient more vulnerable to the unusual infection.

Covid-19 has been linked to a variety of secondary bacterial and fungal diseases, but researchers believe India’s second Covid-19 wave has created an ideal environment for mucormycosis.

According to Reuters.com, low oxygen, diabetes, high iron levels, immuno-suppression, and other conditions, such as prolonged hospitalization with mechanical ventilation, create an ideal environment for getting mucormycosis, according to researchers who published their findings in the journal Diabetes and Metabolic Syndrome: Clinical Research and Reviews.

Diabetics, Covid patients, cancer patients, and persons on long-term steroids are reported to be at a greater risk of acquiring the fungal infections. Even a long stay in the intensive care unit is considered to raise the risk of black fungus.

So far, the only known treatment for yellow fungus has been injections of Amphotericin B; an antifungal medicine also used to treat black fungus. Mucormycosis treatment is expensive. The primary therapy for the illness is surgical excision of the affected tissue, along with a lengthy course of anti-fungal medication. The symptoms of these fungal diseases have been reported to have appeared nearly two-three days after a person had recovered from the Covid-19 infection

To avoid complications, get medical attention as soon as possible. It is believed that carefully treating Covid-19 patients with the appropriate dose and duration of steroids can help lower the chance of fungal infections.

Mohammad Sami Salman Bhuiyan is a civil servant currently studying biochemistry and microbiology. He is also a freelance writer and a research intern at NSU Genome Research Institute (NGRI).

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