Government Advisory on Black Fungus or Mucormycosis
Black fungus or Mucormycosis is a fungal infection mostly affecting the COVID-19 patients with uncontrolled diabetes and prolonged intensive care unit (ICU) stay, and which may turn fatal if uncared for.
In an advisory issued last month, the government said that the fungal infection mainly affects people who are on medication that reduces their ability to fight environmental pathogens.
The evidence-based advisory for screening, diagnosis, and management of the disease was released by the Indian Council of Medical Research (ICMR) and the Union health ministry.
Mucormycosis or black fungus is a serious complication caused by a group of fungi called mucor. It mainly affects people with lowered immunity due to various reasons.
Without proper treatment, Mucormycosis can cause vision loss or even be fatal.
It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or other types of skin injury.
What are the signs of Mucormycosis?
Sinusitis, blocked nose, blackish or bloody discharge
One-sided facial pain, numbness, or swelling
Toothache or loosening of teeth
Blackening or discolouration over the nose
Pain and redness around eyes/nose
Blurred or double vision with pain, fever, headache
Breathing difficulties and coughing of blood
Altered mental status
How does a person develop it?
By inhaling fungal spores from the air
By coming in contact with spores through a cut, scrape, or burn in the skin
Who is at risk of developing it?
COVID recovered individuals who fulfill one or more of the following conditions may be at a higher risk of developing it.
Weakening of immune system due to use of steroids
Prolonged ICU/hospital stay
Use of immunosuppressants
Have undergone fungal infection treatment
Relation between COVID-19 and Mucormycosis
As per the Ministry of Health and Family Welfare, “In the normal course, our body’s immune system successfully fights such fungal infections. However, we know that COVID-19 affects our immune system. Moreover, the treatment of COVID-19 patients involves the intake of drugs like dexamethasone, which suppresses our immune system response.”
“These make COVID-19 patients more susceptible to the infection. In addition, COVID-19 patients undergoing oxygen therapy in ICU, where humidifiers are used, are prone to fungal infection because of exposure to moisture.”
How is it diagnosed?
Apart from a clinical examination based on symptoms, blood test, MRI, CAT scan or biopsy may be required to confirm a diagnosis.
How is it treated?
Mucormycosis is a serious condition that requires immediate medical attention.
This may include management of pre-existing conditions, medications, surgical procedures, and follow-up for at least four weeks.
How can it be prevented?
COVID-19 patients undergoing oxygen therapy must be safeguarded from the possibility of infections. Thus caretakers must ensure the following additional care –
1. The piping must be sterilised.
2. The water used in humidifiers must be sterilised and changed frequently.
Post recovery, the following essential practices must be adhered to –
1. Management of diabetes and regular monitoring of blood sugar levels
2. Maintenance of strict personal hygiene
3. Using steroids, anti-biotics, and anti-fungal medication only as directed by the doctor. Self-medication must be completely avoided
4. Double masking or using an N95 mask if stepping out is unavoidable
5. Avoiding activities that involve direct contact with soil such as gardening. If not possible, it is recommended to wear shoes, long trousers, long-sleeved shirts and gloves
6. Avoiding direct contact with water-damaged buildings and flood water after natural disasters.
Is Mucormycosis contagious?
Any discharge must be disposed of in a sanitary manner. However, it is not contagious.
How long should we follow these precautions?
It may take up to six months for an individual to fully recover from the after-effects of COVID-19.
It is advisable to take all precautions till then.