The Financial Express

Dealing with black and white fungi

Dealing with black and white fungi

While the nation is engaged in a protracted battle against Covid-19 pandemic, yet another kind of morbidity is learnt to have been looming on the horizon. It is a deadly fungal infection known as black fungus, or mucormycosis. The fungus behind this disease, 'mucor mould' or 'mucormycetes' is found in rotting bread, plant, fruit, vegetables, soil, manure, etc.It may also float in the air.  The fungus might be inhaled, or it may also enter the body through cuts and burns in the skin.

Normal people with good health are not at risk from the disease. But those with weak immune system due to their having terminal diseases like diabetes, cancerand  HIV/AIDS, are susceptible to this kind of infection.  Especially, those recovering from Covid-19 may be at risk if they have been using antibiotics and immunity-modulating drugs like steroids.

The black fungus infections have meanwhile reached epidemic proportions in some states of India leading the government to urge states to make mucormycosis or black fungus a notifiable disease(that is, whenever someone complains about black-fungus-like symptoms, it has to be notified to the authorities concerned) under the Epidemic Diseases Act of India. What is most worrying is that more than 7,200 people have reportedly been infected by the fungus in India of whom219 patients have died.As the worst black fungus-affected state, Maharashtra alone has 1,500 reported cases

Five states of India-Tamil Nadu, Telangana, Gujarat, Odisha and Rajasthan-have declared black fungus as an epidemic.

The reason for alarm against black fungus is that the infection has a mortality rate of around 50 per cent. The organs of the body that are affected by black fungus or mucormycosis include face, nose, orbit of the eye, the sinuses, the lungs and the brain.

The person so affected may show symptoms including stuffy and bleeding nose, swelling of the eye accompanied by pain, drooping eyelids, blurred and ultimately lost vision. Also, black patches of skin may appear around the nose.

To avoid the infection from reaching the brain, the affected eye or jawbone of the patient is often surgically removed resulting in permanent disfigurement of the person concerned. But if the patient's brain is affected there is little chance of her/his survival.

Meanwhile, the health department of the West Bengal state of India has issued elaborate advisory warning the people against the dangers of black fungus infection, which include, the probable sources of contracting the disease, symptoms that an infected person might show and so on.

Bangladesh must take all precautions against this new kind of infection. Considering the close proximity of some Indian states to Bangladesh, the potential of black fungus spreading to Bangladesh cannot be dismissed out of hand. In fact, two persons suspected of carrying the fungal infection have been detected in Bangladesh. They have been under observation and treatment at the BIRDEM hospital. Unfortunately, one of the patients has died. In the circumstances, one cannot say that Bangladesh is immune from black fungus infection. People recovering from Covid-19 infection and having comorbidities related to diabetes, renal failure, cancer and so on should take special care to avoid black fungus infection. Their doctors need to be very careful about using immuno-suppressant drugs like steroids. Indian doctors closely monitoring the black fungus or mucormycosis patients have reported that incidence of the fungal infection has some connection with the use of steroids in the treatment for Covid-19 disease.

In the circumstances, Bangladeshi epidemiologists and doctors will have to be in close touch with their Indian counterparts and share information with one another to remain updated about the infection. Under any circumstances, any panic reaction among the public surrounding the black fungus infection should avoided at all costs.

The epidemiologists and doctors of the Indian subcontinent are perhaps at their wits' end. First came the Covid-19. It looks like an unending struggle being waged against this pandemic as it is now in its third phase. And to make matters worse, this new phenomenon of black fungus infection has joined the fray. And as if that is not enough, we are now hearing about what they have termed 'white fungus'. Though they both belong to the family of microbes called 'mucor mould' or 'mucormycetes,'this new variety of the fungal infection is reportedly deadlier than the black fungus. As far as could be gathered about this beast, it can affect the brain, the respiratory organs, digestive tract, kidneys, nailbed and the genitals. According to Indian doctors dealing with this new kind of fungal disease, patients on oxygen support are at greater risk of contracting white fungus. As it (white fungus) attacks lungs and chest, the symptoms may show up as cough, chest pain, breathlessness, headaches, pains and swelling of infected organs.

Such patients may suffer damage to their skin. Both kinds of infection in a person can be detected through X-ray or CT scans. Early detection of the infection is crucial to avoid fatality. The anti-fungal drug, Amphotericin-B, is used to treat patients infected by both kinds of fungi.

It is important to note that unlike Covid-19, the said fungal infections are not contagious. Even so, people having their immune system compromised due to Covid-19 infection need to be especially careful. Use of steroids in the treatment of Covid-19, doctors believe, increases the risk of the convalescing patients' getting infected either by black or white fungus.

So, what are the best ways for the general public to avoid contracting either type of fungal infection? Those include the tested path of keeping clean and following the same health safety protocols-wearing of facemask, observance of social distancing, washing of hands-as they have been doing to fight Covid-19 pandemic.

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