Inside India's 'black fungus' epidemic as cases hit more than 9,000

As India battles the coronavirus pandemic storm, a rapid surge in fungal infection is driving patients to remove their eyes to save their lives.

A rapid rise in cases of mucormycosis, also known as black fungus, has added to the challenges the Indian health system is already facing as it deals with a large second wave of coronavirus infections.

More than 9,000 people in India have been diagnosed with black fungus and the number of cases continues to rise.

Thousands of Covid patients in India have had their eyes removed for black fungus infection as doctors believe the outbreak is caused by steroids used to treat severe coronavirus.

What is black mushroom

Black fungus, or mucormycosis, is a fungal infection that causes blackening or discoloration of the nose, blurred or double vision, chest pain, difficulty breathing, and coughing up blood.

The disease is closely related to diabetes and diseases that affect the immune system. Experts have said that overuse of certain drugs that suppress the immune system during the coronavirus pandemic could cause the surge.

Mucormycosis has a 54% death rate, data from the US Centers for Disease Control and Prevention shows.

Symptoms include blackening or discoloration of the nose, blurred or double vision, chest pain, difficulty breathing, and coughing up blood.

Is it contagious?

The disease is not contagious, so it cannot spread through contact between humans or animals, but through fungal spores that are present in the air or in the environment and can hardly be avoided.

“Bacteria and fungi are already present in our bodies but are kept in check by the body’s immune system,” said K Bhujang Shetty, director of Narayana Nethralaya, a specialized eye clinic.

“When the immune system breaks down from cancer treatment, diabetes, or the use of steroids, these organisms have the upper hand and multiply.”

What is causing the outbreak?

Some experts say unsanitary conditions could increase the risk of developing the infections.

“The tubes used for oxygen, the cylinders used, and the humidifiers used are very dirty,” said Nishant Kumar, an ophthalmologist at the Hinduja Hospital in Mumbai.

A medical worker treats a patient infected with mucormycosis

“If you’re immunocompromised and have been on those pipes and oxygen atoms for a long time, those infections are a lot more ways to get involved.”

On this point, however, opinions are divided.

“Hospitals were dirty even before April. We need epidemiological studies to assess why these cases are now increasing,” said P. P. Kalantri, senior physician and researcher at the Mahatma Gandhi Institute of Medical Sciences in Maharashtra.

Why do Covid patients get black fungus?

Coronavirus has been linked to a wide variety of secondary bacterial and fungal infections, but experts say India’s second wave of Covid-19 created the perfect environment for mucormycosis.

Low oxygen levels, diabetes, high iron levels, immunosuppression combined with several other factors, including prolonged hospitalization with mechanical ventilators, create an ideal environment for contracting mucormycosis, researchers wrote in the journal Diabetes & Metabolic Syndrome: Clinical Research and Reviews.

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