Black fungus symptoms explained amid call to declare mucormycosis epidemic in India

Indian states have been asked to report all cases of mucormycosis—referred to as black fungus—to the country’s health department as infections have been spreading among the country’s COVID patients.

Mucormycosis is a life-threatening fungal infection. Doctors think it’s being driven partly by the steroid medication used to treat some COVID patients in India, the BBC reported. While steroids may help lessen the symptoms of COVID, they also reduce the activity of the immune system.

Lav Agarwal, a joint secretary in India’s Ministry of Health and Family Welfare, called on states around the country to list mucormycosis as a notifiable disease under the Epidemic Diseases Act 1897. That would mean any suspected or confirmed cases would have to be reported to the health department.

Agarwal said black fungus infections are “leading to prolonged morbidity and mortality amongst COVID-19 patients.”

The Times of India reported that the states of Tamil Nadu, Odisha, Gujarat, Telangana, Rajasthan and the territory of Chandigarh had declared mucormycosis an epidemic as of early Friday morning.

Mucormycosis is caused by fungi called mucormycetes. They can be found in soil and decaying organic matter.

People can become infected if they come into contact with the fungus’ spores. The U.S. Centers for Disease Control and Prevention (CDC) states that these fungi aren’t harmful to most people, but that breathing in the spores can cause an infection in people with weakened immune systems.

The symptoms of mucormycosis depend on which part of the body is being affected by the fungal infection.

If the infection occurs in the sinus or brain, it is called rhinocerebral mucormycosis. This causes swelling on one side of the face, a headache, black lesions on the nose or on the inside of the mouth and a fever.

If it attacks the lungs, it is called pulmonary mucormycosis. Patients may experience symptoms such as fever, cough, chest pain and shortness of breath. It can also infect the skin, where it may cause the infected area to become black and swollen, and the stomach.

The CDC describes mucormycosis as “serious but rare” with an overall mortality rate of 54 percent, based on one study of 929 eligible cases. Mortality depends on underlying health conditions and the type of infection.

It can be treated using antifungal medicine such as amphotericin B, but some infections may require the infected tissue to be surgically removed.

Frontline COVID-19 workers in India wave the country’s flag during Independence Day celebrations in Kolkata, August 15, 2020. The country has in recent weeks battled a surge in COVID cases.
Dibyangshu Sarkar/AFP/Getty

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