Pune: A fungal infection as a post-coronavirus complication, mucormycosis, commonly known as ‘black fungus’, is being reported among people in multiple states in the country. The new infection has left hospitals overwhelmed and healthcare workers overburdened.

It is being detected in Delhi, Maharashtra, and Gujarat relatively among COVID-19 patients.

WHAT IS MUCORMYCOSIS

Although considered as rare, mucormycosis is a serious threat. Mucormycosis was previously called zygomycosis. It is a serious but rare fungal infection that has been affecting recovered or recovering patients who have suffered COVID-19. According to the US Centre for Diseases Control and Prevention (CDC), mucormycosis infection is caused by a group of molds called mucormycetes that are widely found in the environment.

It mainly affects people who are on medication for health problems that reduce their ability to fight environmental pathogens, experts from the COVID-19 task force informs.

It is being found in COVID-19 patients with uncontrolled diabetes and prolonged intensive care unit (ICU) stay, may turn fatal if uncared for, the Centre stated on Sunday. In an advisory issued by the government, it also stated the fungal infection mainly affects people who are on. "Mucormycosis, if uncared for, may turn fatal. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from the air," it said.

WHAT ARE ITS SYMPTOMS

People who have health problems or take medicines that lower the body’s ability to fight germs and sickness are more vulnerable. People with diabetes, cancer or those who have had an organ transplant are more vulnerable for this infection. COVID 19 patients carrying this infection may start witnessing pain and redness around eyes or nose, along with fever, coughing, shortness of breath and vomiting. The patient can also see Sinusitis, a nasal blockade or congestion.

One sided facial pain, numbness, swelling, toothache, loosening of teeth, chest pain, pleural effusion, haemoptysis are some other symptoms.

HOW TO PREVENT IT

One should note that it is a rare disease. However, some groups of people are more vulnerable than others. Use masks if you are travelling at any construction sites. One must wear shoes, long trousers, full sleeve shirts and gloves while handling soil (gardening), moss or compost.

The disease can be managed by controlling diabetes, discontinuing immunomodulating drugs, reducing steroids. Good blood sugar control is a must for all diabetic patients. This becomes even more vital with the use of steroids during the treatment of COVID. Regular blood sugar monitoring is a must for all patients using oral steroids. Self-prescribed and unmonitored use of steroids should be strictly avoided. Maintain personal hygiene, including thorough scrub bath.

DIAGNOSIS AND TREATMENT

It is dependent on the location of the suspected infection. A sample of fluid from your respiratory system may be collected for testing; otherwise a tissue biopsy or a CT scan of your lungs, sinuses and more may be conducted.

Treatment of mucormycosis may require a team of doctors from multiple specialties including an ENT surgeon, Neurologist, Endocrinologist, Ophthalmologist and Dental surgeon. Since poor blood sugar control is the most vital risk factor, treatment for control of blood sugars is important. The treatment of infection itself requires a combination of medicines and surgery. Some antifungal drugs are effective in slaying the virus and have to be started as soon as possible. These are given as injections after doctor’s advice. The medicines themselves are unable to fully control the infection and have to be combined with removal of infected tissue.

MAHARASHTRA TO PROVIDE FREE TREATMENT

Amid the rise in the cases of mucormycosis among the COVID-19 patients, the Maharashtra government on Monday declared to provide free treatment to patients with the fungal infection.

Maharashtra Health Minister Rajesh Tope on his Twitter handle wrote, "In some districts of the state, COVID-19 survivors are suffering from a fungal disease called mucormycosis. The health department has taken serious note of it. An awareness campaign will be launched and patients with mucormycosis will be treated free of cost under the Mahatma Jyotiba Phule Jan Arogya Yojana."

Tope said that the cost of medicines to treat fungal infection is expensive and hence, the patients will be treated free of cost in 1,000 hospitals under the Mahatma Jyotiba Phule Jan Arogya Yojana.

DOS AND DON'T

· Control hyperglycemia (high blood sugar).

· Monitor sugar level post COVID-19 .

· Check correct timing, correct dose and duration of steroids.

· Use clean, sterile water for humidifiers during oxygen therapy.

· Use antibiotics or antifungals carefully.

· Do not miss symptoms.

· Do not hesitate to seek aggressive probe, as appropriate (KOH staining & microscopy, culture, MALDITOF), for detecting fungal etiology.

· Do not waste time to initiate treatment for the infection.