India reports new deaths due to Covid-linked ‘black fungus’ as outbreak spreads to more cities

An increasing number of black fungus cases are being reported across India with deaths being reported in multiple states as the deadly Covid wave sweeps the country.

There have been 10 reported deaths, eight in Maharashtra’s Thane and two in Madhya Pradesh, due to the fungal infection, but doctors say there could be more deaths tied to the infection.

The cases of mucormycosis, a rare but dangerous fungal infection, have been reported in the Indian states of Delhi, Maharashtra, Gujarat, Madhya Pradesh, Karnataka, Rajasthan, Odisha and several others.

Mucormycosis can be caused by mucor moulds which are found in soil, plants, manure and even contaminated air or water.

“Mucormycosis is a ferocious fungus and usually fatal if left unattended for one to three days,” Dr Anchal Gupta, senior eye surgeon at Netram Eye Foundation in Delhi, told The Independent.

The disease can lead to permanent loss of vision, hemiparesis, destruction of facial structures and even death in some cases, she said.

Doctors believe mucormycosis can be induced in the Covid patients by the over use of steroids, a life-saving treatment for critically ill Covid-19 patients.

It can also be triggered in severely immunocompromised individuals or acquired in hospitals through ventilation systems in ICUs.

Dr Gaurav Kumar of Ram Manohar Lohia hospital told The Independent that mucormycosis is emerging as a significant challenge for doctors in the second wave of Covid-19 and the case of fungal infection is rising as the cases of coronavirus are surging.

Steroids and some drugs that are used to treat Covid-19 also suppress the immune system. “But the over judicious use of steroids can shoot up the blood sugar level and those with uncontrollable sugar face risk of fungal infection,” Dr Kumar said.

Doctors believe that patients with black fungus infection have an overall mortality rate of 50 per cent.

Rajesh Tope, health minister of Maharashtra, the worst-hit state in India, said the region could alone have as many as 2,000 cases of black fungus. He announced free treatment for patients of black fungus and said eight people had succumbed to the infection in the state so far.

The western state of Gujarat has reported the highest number of mucormycosis cases, at 100, with authorities racing to create separate wards for the treatment of those patients. People were seen queuing up to buy injections which are reported to be sold at a high price due to a surge in demand.

Madhya Pradesh has reported 13 cases, while two have died in the state. The city of Jaipur in Rajasthan has seen 14 patients with the infection in the last 12 hours.

Dr Gupta said in cases where it “invades the brain, the infection starts by spreading through the mucosal paranasal sinuses and airspaces into the brain”.

“Timely clinical diagnosis is required in high risk cases with confirmation from CT and MRI scan,” she said. “Treatment is done with high doses liposomal injection known as Amphotericin B and surgical debridement.”

The emergence of a large number of cases forced the health ministry on Sunday to release an advisory on how to treat the infection.

While authorities have not published national data on mucormycosis, officials said there was no major outbreak. "It’s not something to panic about, but you have to be aware of when to seek consultation,” Aparna Mukherjee, a scientist at the federal Indian Council of Medical Research (ICMR), said.

The central government has decided to ramp up production on Amphotericin B, which is being used on patients suffering from mucormycosis.

As queues were seen in places in Gujarat to buy the vials, the central government said they would import the medicine and increase domestic production.