States in India have started declaring an outbreak of ‘black fungus’ as cases of the rare fatal infection increase in patients recovering from Covid-19.
The fungal disease, called mucormycosis, has a mortality rate of 50%. It initially affects patients in the nose, but the fungus can then spread to the brain and often can only be treated with major surgery removing the eye or part of the skull and jawbone.
It is usually a rare disease, but more than 7,200 people in India have now been reported with mucormycosis and 219 have lost their lives. The increase in black fungal infections, mainly in patients who have had severe cases of Covid-19, has been linked to overuse of steroids in the treatment of coronavirus, which can severely compromise the immune system if taken over an extended period. The high incidence of diabetes in India has also been blamed, with high blood sugar levels linked to sensitivity. India has the second highest rate of diabetes in the world.
It has also been reported in Covid patients who were on ventilators in intensive care units, due to exposure of their airways to moisture and humidity.
The disease is caused by fungal spores found in soil and organic matter, usually inhaled by humans from the air. The mold enters the body and then manifests around the nose and eye sockets, causing the nose to blacken and, if not stopped, will move fatally around the brain. Healthy individuals usually fight off the fungus, but it can spread quickly in those with compromised immunity.
So far, five states, Tamil Nadu, Odisha, Gujarat, Rajasthan and Telangana, have declared the black fungus an epidemic, and more states are expected to follow suit. The Indian Council of Medical Research has published an opinion on the diagnosis and treatment of the disease.
Maharashtra, the first state to be hit hard by India’s second wave of Covid, has already reported more than 1,500 cases and 90 deaths, the highest in the country. Delhi hospitals have also started reporting an unprecedented increase in cases – up to 15 to 20 new cases per day in some hospitals, compared to previous rates of one or two cases per month. In Delhi and Bangalore, there are now waiting lists for beds for treatment of the disease.
Dr Amit Thadhani, director of Niramaya Hospital in Mumbai, said his colleagues have started seeing cases of black fungi in patients with severe Covid. “Almost all of the patients are diabetic or immunocompromised,” he said.
Delhi Health Minister Satyendar Jain said on Friday that there were 197 cases of black fungus in hospitals in the city and special black fungus rooms have now been set up in major government hospitals to cope. to the influx of patients. Jain blamed the “very dangerous” misuse of steroids to treat Covid-19 as a cause of the outbreak.
Balram Bhargava, director of the Indian Council for Medical Research, said of the black fungus: “If a person’s immunity is taken away, they will infect them. If the spores have access to a high sugar content [levels], it will grow. We have seen this happen with patients with Covid-19 who have diabetes and uncontrolled sugar, or who are immunosuppressed or who have received immunosuppressants. “
The epidemic is spreading rapidly. In Gujarat, there have been 371 cases in the state capital, Ahmedabad, and another 400 in Rajkot, a city hard hit by Covid-19. Goa has so far recorded six cases of mucormycosis. The first case in Kashmir was detected on Friday.
The increase in cases has led to a shortage of drugs. The Delhi High Court on Thursday called on the central government to procure life-saving antifungal drugs “wherever they are available in the world … time is running out, and so are human lives.” The government said the shortage was being resolved and more drug companies had been approved to produce the injections.