'Diabetes and steroid use not the only possible reasons for contracting mucormycosis': Top doctor
At a time when health experts are concerned about the rising number of mucormycosis, or black fungus, cases in the country, principal scientific adviser to the government of India, Dr K VijayRaghavan, shared a thread on micro-blogging website Twitter which explains what causes the infection and how people can lower their chances of contracting it. The twitter thread has been creatd by Dr Pramesh CS, director of Tata Memorial Hospital.
Mucormycosis is a very rare infection which is caused by exposure to mucor mould (a fungus) which is commonly found in soil, plants, manure, and decaying fruits and vegetables. In the Twitter thread, Dr Pramesh has explained how the mucor spreads.
"Mucor is a fungal infection caused by “mucormycetes”, a group of fungi. These fungi are ubiquitous - in soil, fallen leaves, compost, and air. Yet, most of us don’t develop the disease," he said.
"How does someone get infected with mucor? Most commonly, it is inhaled through the nose. Wearing a mask therefore, probably helps prevent it. Is mucor contagious? No - you can’t get infected by being in close contact with someone else who has the disease," he further added in the series of tweets.
He then talks about what makes people more prone to developing mucor? Dr Pramesh said that by far the most important reason is reduced immunity. "There are several reasons for this - diabetes, being on steroids, taking immunosuppressant drugs, chemotherapy, and so on," said Dr Pramesh.
He also said that diabetes and steroid use are not the only possible reasons for the spread of the infection. "We’ve also heard about possible industrial grade oxygen, tap water in humidifiers, reused masks, antibiotic overuse, all being possible reasons. Again, the truth is that we just don’t know," said Dr Pramesh.
The top doctor then went on to talk about the chances of contracting mucor. The first thing he said is to make sure blood sugar levels of diabetics remain in control. Dr Pramesh also said that steroids should not be used unless prescribed by a doctor. "Indiscriminate steroid use harms in two ways - first it reduces your immunity; second, it raises your blood sugar levels. Both of these predispose you to getting infected with mucor," he said.
He, however, did not say that steroids should not be used on Covid-19 treatment, but asked people to be careful about not using them when they are not required.
The symptoms listed by Dr Parmesh include swelling of one side of the face, a feeling of stuffed nose, headache, red eyes, blackening of the bridge of nose or palate, discharge from the nose, and fever. He cautioned that mucormycosis should not be managed at home. "Mucor requires urgent hospitalization and treatment - please get admitted in a hospital," he said on Twitter.
Mucormycosis affects the sinuses, the brain and the lungs and can be life-threatening in diabetic or severely immuno-compromised individuals such as cancer patients or people with HIV/AIDS.
The doctors in India are documenting an alarming number of cases of mucormycosis among patients with Covid-19 and those who have recently recovered. They believe that mucormycosis may be triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients.
Eleven states and Uniomn territories have declared mucormycosis as an epidemic under the Epidemic Diseases Act, 1897. The Union health ministry reported 5,424 cases of mucormycosis across India, out of which 4,556 patients have a history of Covid-19 infection with 55 per cent diabetics.