They recovered from COVID but died of “black fungi”.

In early May, Indian doctors began warning about the increase in mucormycosis. This is a rare and deadly infection, also known as black fungus.

Many infected people are coronavirus patients, or those who have recently recovered from COVID-19, whose immune system is weakened by the virus or suffers from an underlying disorder, especially diabetes.

This is what we know about black mold and its epidemic in India.

How do you get it and what are the symptoms?

Black ear mushrooms are caused by mold found in moist environments such as soil and compost and can attack the respiratory tract.

It is not contagious and does not spread from person to person.

Black fungi generally affect the sinuses or lungs after a person inhales fungal spores in the air, and can also affect the skin after surface damage such as cuts and burns.

Symptoms depend on where the fungus grows in the body, but include swelling of the face, fever, skin ulcers, and black lesions in the mouth.

“It can then spread to the eyes and lungs and to the brain. It can lead to darkening and discoloration of the nose, blurred vision and diplopia, chest pain, dyspnea, and hemoptysis.”

“One way mucormycosis progresses is to invade blood vessels,” said Dr. Hemant Soccer, a consultant and cardiac metabolism expert at Breach Candy Hospital in Mumbai.

“It jeopardizes circulation to the distal organs and thus produces what is called tissue necrosis or death, which then turns black, so it is named the black fungus.”

In the most severe cases, the infection “enters the brain through blood vessels,” he added, which can lead to poor vision and “gap holes” in the face.

“Uncontrolled and untreated, mortality rates can range from 20% to 50%.”

Mortality also depends on the type of fungus involved and which parts of the body are affected. For example, it is not fatal to people with sinus infections, but it is fatal to people with lung infections.

What is the link to COVID-19?

According to the Indian Ministry of Health, immunocompromised people are more susceptible to infections, including COVID-19 patients, diabetics, people taking steroids, and people with other comorbidities such as cancer and organ transplants. That is.

Patients with COVID are particularly vulnerable because the virus not only affects the immune system, but therapeutic agents can also suppress the immune response.

“Because of these factors, COVID-19 patients face a new risk of failing to combat microbial attacks such as zygomycosis,” the ministry said of the fungus that causes zygomycosis.

COVID patients receiving oxygen therapy in the ICU may have a humidifier in their ward. This increases exposure to water and can make you more susceptible to fungal infections.

“The fungus takes the window of opportunity and invades the body,” said Dr. Soccer.

“This body has small openings for COVID, sugar (hyperglycemia), antibiotics-for many other reasons (black fungus) builds a foothold.”

“This does not mean that all COVID patients are infected with mucor disease,” the ministry warned, as it is rare among non-diabetics.

“India is the world’s diabetic capital,” said Dr. Soccer.

“We have a tropical climate where fungi are widespread, so all of this has led to a black fungal epidemic.”

Patients may need up to 6 weeks of antifungal medication to recover. Their recovery depends on how quickly the disease was diagnosed and treated.

Surgery is often needed to remove dead or infected tissue.

“In some patients, this can result in loss of the maxilla and, in some cases, eyes,” the Indian Ministry of Health said in a statement.

Demand for amphotericin B is increasing in India, but supply is in short supply as hospitals did not predict the number of cases.

Bhavya Reddy, who lives in Telangana, southern India, said he was diagnosed with a black fungus on April 26, just as his father was recovering from COVID-19.

“As he began to recover (from COVID), his face began to swell,” Lady said.

“When the swelling didn’t go away, (the doctor) told us to get an injection.”

She said the hospital had no supply of amphotericin B and she had to appeal to the state prime minister to receive a vial of the drug.

Once the drug was available, her father underwent endoscopic sinus surgery to relieve the swelling.

Mansukh Mandaviya, Deputy Secretary of the Ministry of Chemicals and Fertilizers, tweeted Thursday, adding that five companies in addition to the existing six have been approved to manufacture medicines in India.

Although the disease is globally distributed and generally fairly rare, the lack of comprehensive monitoring and data can make it difficult to accurately estimate its prevalence.

According to the CDC, laboratory surveillance in the San Francisco Bay Area from 1992 to 1993 suggested an annual incidence of 1.7 per million people in the United States.

There are several possible reasons-the study states that India has a high rate of “uncontrolled diabetes.”

Many patients they studied did not even know they were diabetic until they were diagnosed with the black fungus, and showed “lack of regular health checks in the Indian population.”

India’s black mortality rate is also “quite high due to delays in doctor consultation and diagnosis of the disease, and challenges in managing the stages of infection,” the study said.

The climate of the country is also a factor, Dr. Soccer said.

“This fungus can grow on the sides of bread that is stored outside,” he said.

“It can grow anywhere in the form of mold, but in moist tropical countries … it tends to get worse.”

He added that the current outbreak may be due to “we are hot and humid during the summer.”

“Everyone knows that fungal infections occur in these types of climates.”

Where are you reporting?

To date, more than 3,200 cases of black fungus have been recorded in five states: Maharashtra, Madhya Pradesh, Haryana, Telangana, and Gujarat.

Maharashtra has the highest number, with more than 2000 reported and 800 hospitalized. At least 90 people have died of the disease in the state.

Gujarat reports at least 369 cases in just one hospital.

On Thursday, the central government classified mucormycosis as a notable disease. This means that all states and federal regions must report cases to federal authorities.

India’s Prime Minister Narendra Modi said on Friday, “We are now facing a new challenge for black mold. We need to be careful and prepared for it.”

According to their respective state officials, at least seven states have declared black ear mushrooms a notable disease, following central government recommendations for collecting data.

“There are many complications because these cases are found in patients who have recovered from COVID,” said JV Modi, medical supervisor at Ahmedabad Municipal Hospital, Gujarat.

He added that the number of hospital cases has increased over the past decade as the country appeared to have passed the peak of the second coronavirus wave.