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After Rajasthan, Telangana Declares Black Fungus an Epidemic. What is Mucormycosis and Why is it Fatal?

File photo of patients suffering from the coronavirus get treatment at a Delhi hospital. (Image: Reuters)

File photo of patients suffering from the coronavirus get treatment at a Delhi hospital. (Image: Reuters)

According to Dr Ajay Swaroop, Chairman, Department of ENT at Sir Ganga Ram Hospital, Covid-19 patients with weak immunity are more prone to this black fungal mucormycosis disease.

Even as India reels under the second wave of Covid-19, doctors at Delhi-based Sir Ganga Ram Hospital (SGRH) have again reported multiple cases of deadly fungal infection mucormycosis in the recovering coronavirus patients. The black fungal infection, triggered by Covid-19, last year caused many of the patients to lose their eyesight.

According to Dr Manish Munjal, a senior ENT surgeon at SGRH, the hospital has admitted six patients with mucormycosis infection in the last two days. “We are seeing a rise again in this dangerous fungal infection triggered by Covid-19. In the last two days, we have admitted six cases of mucormycosis. Last year, this deadly infection caused a high mortality with many patients suffering from loss of eye sight, removal of nose and jaw bone,” he said.

WHAT IS MUCORMYCOSIS?

It is also known as zygomycosis. According to the CDC (Centre for Diseases Control and Prevention), this rare but critical fungal infection is caused by a group of molds known as mucormycetes. These molds are present naturally in the environment. However, it affects humans when the body’s immunity system has been weakened and it is vulnerable. It affects the lungs and the sinuses following inhalation of fungal spores from the air. The fungus can also enter the body through open wounds or cuts.

“These fungi aren’t harmful to most people. However, for people who have weakened immune systems, breathing in mucormycete spores can cause an infection in the lungs or sinuses which can spread to other parts of the body,” the CDC had said last year.

The CDC had also clarified that mucormycosis is not contagious. That means, it cannot transmit between people and animals. “Early recognition, diagnosis, and prompt administration of appropriate antifungal treatment are important for improving outcomes for patients with mucormycosis,” the CDC had stated.

WHO ARE LIKELY TO GET INFECTED?

According to Dr Ajay Swaroop, Chairman, Department of ENT at Sir Ganga Ram Hospital, Covid-19 patients with weak immunity are more prone to this black fungal mucormycosis disease.

“Use of steroids in treatment of coronavirus infection and the fact that many Covid-19 patients have diabetes as co-morbidity could be one of the reasons for this rise in black fungus cases again. Covid-19 infected patients with weak immunity are more prone to this deadly infection,” he explained.

WHAT’s THE TREATMENT?

It is being said that the “overall mortality rate is around 50 per cent”, but early identification and treatment can lead to a better outcome.

Varun Rai, consultant ENT surgeon at SGRH had last year said, “Early clinical suspicion on symptoms such as nose obstruction, swelling in the eye or cheeks, and black dry crusts in the nose should immediately prompt the conduct of a biopsy in the OPD and start of the antifungal therapy as early as possible.”

This year, a Mumbai-based bio-pharmaceutical firm received approval from drug regulatory authority to use an anti-fungal drug for the treatment of mucormycosis.

The firm, Bharat Serums and Vaccines Limited, became the first company in India to receive the approval from Drug Controller General of India (DCGI) to use anti-fungal medication — Liposomal Amphotericin B or LAmB — as a medical intervention in patients of mucormycosis, reported IANS.

Vishwanath Swarup, COO, Bharat Serums and Vaccines (BSV), had said that anti-fungal medication can prevent the patients suffering from black fungus from progressing the stage of surgery. “BSV is indigenously developing and manufacturing the formulation of Amphotericin B including Liposomal Amphotericin B and Lipid Complex Amphotericin B – the anti-fungal medications that have been recommended for use in life-threatening fungal infections such as mucormycosis. Also, BSV is the first Indian company to get the regulatory approval of Liposomal Amphotericin B,” he added.

HAS IT BEEN REPORTED IN OTHER CITIES BEFORE?

Yes, the infection was reported last year in Gujarat’s Ahmedabad and Karnataka’s Bengaluru. In Ahmedabad, mucormycosis was reported in five patients who were all either suffering from Covid19 or had recovered from it. According to a media report, two of these five succumbed to the infection while two among the survivors lost their eyesight.

In Bengaluru, mucormycosis was reported in four Covid-19 patients. Of these, two patients died.

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