No need for panic, but do not waste time: Experts on mucormycosis

There cannot be anything blacker than mucormycosis in these already dark times. Expert Dr Sanjay Agarwal clears air about feared and much-misunderstood fungus

The V Citizens Action Network (V-CAN), a public trust whose objective is to establish a linkage between citizens and their government representatives, held a webinar on Thursday on Black Fungus: Understanding the Mystery, with guest speaker Dr Sanjay Agarwal, head, Department of Medicine and Diabetes, Ruby Hall Clinic and senior consultant in Diabetes and Medicine, Jehangir Hospital.

New challenge?

Managing trustee Indrani Malkani said at the outset, “Mucormycosis or black fungus is the new challenge thrown up by Covid-19. It is vital for citizens to understand it. We must know the category of people who are most susceptible and apart from black fungus, we are also hearing about white and yellow fungus. We are pretty bewildered though certain that Dr Agarwal will clear the fog in our minds.”

Covid-19 chameleon

Dr Agarwal said, “Covid-19 is a very interesting virus and keeps changing like a chameleon, we have to keep marching ahead of it. You will be amazed at the number of mutations that have happened across the country. It keeps us guessing.”

The expert speaker moved on to mucormycosis. He stressed, “We have seen mucormycosis in patients with diabetes when there was no Covid-19. Today, there seems to be a sudden and to many, a scary surge.”  

Also Read: 3,200 Black fungus cases recorded in Maharashtra: State govt to Bombay High Court

For Dr Agarwal, numbers do the talking. He said, “Currently, there are 8,800-plus cases across the country and 2,000-plus in Maharashtra.” In layman’s lingo, the doctor explained, “When you have an environment where immunity is compromised then the body cannot take care of the fungus. It becomes invasive and starts creating a problem.” 

Going to basics, the doctor clarified, “Mucormycosis is not spread by oxygenation, humidifiers and water. The fungi remain indoors and outdoors and they enter the respiratory tract via air. There are some linkages with zinc or iron, we understand that it may be one of the strong associations.” The doctor cited other strong linkages like “steroid overuse, poor sugar control and immunosuppressants.”

Studies showcase

There is a propensity to press the panic button. So, Dr Agarwal cautioned, “Citing certain linkages does not mean every patient who gets oxygen, steroids or immunosuppressants gets mucormycosis. Studies also show this is not so. Please do not get into your head that if I am given oxygen, I will be heading for mucormycosis. There is a basket of factors, there are too many dots to link.”

Early signs

Dr Agarwal outlined some red flags. “Some patients present to us with swollen eyes, drooping of the eyelid, facial pain, vision loss — these are some of the things that immediately draw attention, patients complain of severe headache, there may be loosening of the teeth, a black colour patch on the hard palate and that is where the name black fungus comes from.”

Emphasising that early means everything, Dr Agarwal said, “Recognising signs early is of prime importance. Do not hesitate to go to the doctor.” Giving an example of just how dire delays can be, the doctor said, “If you delay treatment more than six days after diagnosis, it results in a two-fold increase in mortality.”

Having said that, the top medical professional emphasised good hygiene, whether one talks about black, white or yellow fungus, is always a recommended practice.

“Black fungus does not spread through person-to-person contact. Act responsibly and do not panic about Covid-19. For us to come to conclusive evidence, it takes time, clinical studies and research. Please do not be disheartened asking: do drugs work? The answer is yes, we are saving a lot of lives. Adopt Covid-19 apt behaviour, do not have an ostrich-like burying-your-head-in-the-sand attitude, separate the junk from factual reading. Medical professionals are working round the clock to keep you well,” Agarwal said on a reassuring note.

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