Black Fungus: Myths Vs. Facts

In India, rising medical concern about fatal fungal infection has emerged. After the second wave of COVID-19, black fungus infection has rooted panic among people. Various myths are spreading on numerous platforms on the internet. 

Let's see some of the facts about black fungus and bust the myths. Here you will get everything you need to know about black fungus.

What is Mucormycosis?

Mucormycosis is a fungal infection caused by a group of fungi known as Mucormycetes. It's a severe but rare fungal infection that can be fatal if not taken care of it. 

Black fungus is a misnomer because the mucor mould is not black. Instead, there are black dots seen between the mould colonies. The infection causes black coloration of the nose and under the eye area. Hence, the name has been given "Black fungus."

Mucor moulds infect by their spores. Their spores are present everywhere in the surrounding air and soil. It mainly affects sinuses or the lungs by inhaling the spores from the air. Black fungus on the skin also occurs after a cut, burn, or specific skin injury.

How dangerous is a fungal infection?

In a healthy person, the immune system can easily prevent fungal infection. There is a wide range of moulds coloration like white, black, orange. If a person has a weakened immunity, even these harmless fungi can lead to lethal results. 

Fungal infections can lead to death if not taken seriously. They can spread at a very rapid rate after the infection. They can affect the crucial organs of our body like the lungs, brain, eye, oral cavity & GIT tract.

Black fungus symptoms and signs

Black fungus infection can elicit different signs and symptoms depending on the site and the organ affected. Some common symptoms are present in the early stage, but they can be fatal if the symptoms remain unchecked and ignored.

Here are the early symptoms and signs for Black fungus infection:

• Excessive running nose
• Swelling on one side of your face
• Swelling and pain in your eyes
• Dark spots around the nose is a warning sign
• Toothache
• Eyelid loss and blurred vision
• Fever
• Headache
• Coughing
• Shortness of breath
• Chest pain
• Nausea and vomiting
• Blood in vomits
• Blood in your stool

If you are getting any of the above symptoms, then please don't ignore them. Many patients come to the hospital late, missing the early signs. The infection can spread to the eye. In this case, the eye of the patient has to be removed by surgery. In some cases, doctors have to remove even both eyes, even spreading to the brain.

Myths About Transmission 

Some misconceptions about the transmission of Black fungus infection have spread in social media. People are in a panic.

Let's see some of these myths and the facts:

1. Person to person infection

There are certain myths that mucormycosis can spread from person to person contact. The Black fungus cannot transmit from the infected person to a person who possesses strong immunity. It only affects the immunocompromised people. So there is no need to isolate the person because of mucormycosis. 

The black fungus spores are always present in the air and soil. The spore grows where it gets a suitable environment (warm and moist) like your nasal cavities. But your strong immune system keeps it away, although by way of air it will only affect the person with a weakened immune system only.

2. Face masks can transmit the infection.

There are also myths spreading about masks that you should avoid their use. There is no evidence that mucor moulds harbor in them. The use of masks is important but disinfecting them is crucial. Don't use the same mask for weeks.

3. Fungi infect through water, humidifiers, and oxygen cylinders

Myths of fungi spreading through water and oxygen cylinders are no less. Though sterilization and regular cleaning of humidifiers are necessary, mucor moulds don't grow in fluids like water. They cannot grow in pure oxygen. 

4. Onions can transmit the infection.

Some believe that black fungus can grow on onions and can be a source of infection. There is no evidence as such. Please don't blame the onions. The black mould on the onions is Aspergillus niger.

Possible Route of Transmission

There are many research papers available for the source of infection of Mucormycosis. 

• Hospital linens from poorly managed laundries can be a source of the infection.
• Inhalation of spores in the dust, as in construction workers and contracted air, is a possible transmission route.
• Mucor mould can grow on soil, compost, animal excreta, bread, decaying fruits, vegetables, and crop debris.

Why people suffering from COVID-19 develop this infection?

In the present scenario, after the second wave of COVID-19, Black fungus infection affects many recovered COVID patients or patients still suffering from COVID. 

COVID infection weakens your immune system. Further, doctors give steroids in the treatment of COVID. Steroids are specific chemicals like hormones, dexamethasone which is essential in the treatment of COVID. But, prolonged use of these steroids can weaken the immune system to the extent where even fungal infections can be fatal.

Steroids use in severe COVID can save the life of a patient. But misuse of these steroids can be very dangerous.

Who else can develop it?

There are other causes for the infection apart from COVID.

Diseases like HIV/ AIDS, uncontrolled diabetes mellitus, and cancer weaken the immune system. Hence, your body becomes susceptible to fungal infection.

Black fungus infection can infect patients with prolonged steroid therapy. Voriconazole therapy also does the same.

After transplantation, doctors give immunosuppressant to the patients to avoid graft rejection. Hence, the suffering patients can also get Black fungus infection.

For a very long time, the person who has stayed in ICU is also prone to Black fungus infection.

How to prevent yourself?

• Use masks everywhere, especially when visiting a dusty site.
• It would be best if you disinfect your masks regularly
• Avoid using the same mask for weeks.
• Regularly cleaning of humidifiers and sterilization is essential.
• If you have recently recovered from a COVID infection, wear masks everywhere.
• Cover your whole body while working with soil, moss, or manure.
• Maintain personal hygiene.
• Take a thorough scrub bath.
• Brushing and gargling are essential. Don't miss these.
• If you are on steroids, keep monitoring your blood sugar level.
• Take steroids with caution: correct timing, doses, and duration.
• Keep your Diabetes in control.
• Use antibiotics judiciously. Don't self-prescribe.
• Do not avoid the signs and symptoms.

Black fungus treatment

Black fungus treatment should be swift and effective. There should be no delay as it can be fatal if overlooked for even a concise duration. In most severe cases, surgical removal of the infected area is the only way for treatment. 

Let's see treatment options:-

1. Doctors give an intravenous antifungal injection of Amphotericin B. This injection is one of the best choices of doctors. It has saved the lives of many diabetic patients who have recovered from COVID. Its doses depend on the physical weakness of the patients.
2. Reduce the use of steroids to their most minor requirement.
3. Discontinue all the immunomodulation drugs.
4. Doctors give antifungal therapy for at least 4-6 weeks.
5. Surgeons remove all the necrotic cells that are infected to prevent the spread of infection.

Multi-specialist doctors work together to treat a patient.

• Microbiologist
• Biochemist
• Internal medicine specialist
• Dentist
• ENT specialist
• Surgeon
• Intensivist
• Ophthalmologist
• Neurologist

It would be best if you do not ignore the warning signs of black fungus infection. Early diagnosis and treatment are crucial to prevent getting affected by this severe infection. See a doctor if you are having any of the symptoms.