The continuing pandemic Covid-19 has brought in its wake cases of Black Fungus and White Fungus.

The Union Government has urged States and Union Territories to make mucormycosis or black fungus a notifiable disease under the Epidemic Diseases Act. The reason being the infection leads to prolonged morbidity and mortality among the Coronavirus patients.

In a report in news18.com, the Head of Patna Medical College and Hospital Microbiology Department, said the newly detected fungal infections pose a risk to patients on oxygen support and are reported to cause skin damages. He warned that If detected late, it could also lead to death. In fact, he went on to appeal to the Covid-19 and recovering Covid-19 patients to take this fungus seriously.

The report also stated that both the white and black fungus infections were caused by fungi moulds called mucormycetes which are present in the environment, according to a Times Of India report.

The White Fungus

Since this fungus acutely affects the lungs and other body parts, it is considered more dangerous than black fungus according to the health experts. The reason why the white fungus becomes more lethal is because of the way it spreads and causes great damage to the vital organs. It may impact the brain, respiratory organs, digestive tract, kidneys, nailbed or even private parts.

The white fungus is more likely to infect people with low immunity according to a report by indianexpress.com. It can also affect those who come in contact with water or unsanitary environments containing the moulds.

While the disease isn’t contagious, a person can be vulnerable to the infection since these moulds can be easily inhaled by a patient. Spreading to vital organs, the fungus can cause complications.

Those with low immunity, comorbidities, diabetes, cancer or those using steroids regularly are at a higher risk of getting infected with the white fungus.

Those patients who are infected with white fungus manifest symptoms similar to Covid-19. The cases reported in Patna hospital did show Covid-19 related symptoms but they did not test positive for Coronavirus. As the white fungus affects lungs and chest, it may lead to cough, chest pain, breathlessness. Further, the infection may have inflammatory symptoms and cause swelling, infections, persistent headaches and pains.

The infection can be detected through X-rays and CT scans and those affected are given anti-fungal medication for treatment.

The Black Fungus

While the black fungus cases have raised considerable concern among the people, the All India Institute of Medical Science Director Dr. Randeep Guleria has clarified that the fungal infection is not new, but the cases have increased with Covid-19.

He went on to add that “misuse” of steroids was one of the main causes.

He also said that “this disease (Mucormycosis) can affect the face, infecting the nose, orbit of eye, or brain, which can even cause vision loss. It can also spread to the lung. It has been seen that secondary infections, fungal and bacterial, are causing more mortality.”

Those who are diabetic patients, Coronavirus patients and people who are on steroids are at a higher risk of contracting the black fungal infection.

According to an advisory issues by the Indian Council of Medical Research, the major risk factors associated with this type of fungus includes uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICU stay, malignancy and voriconazole therapy.

Black fungus is primarily affecting people recovering from Covid-19 and the infection is causing blackening or discolouration over the nose, blurred or double vision, chest pain, breathing difficulties and coughing blood.

The mucormycosis predominantly involves the sinuses, the eye and at times it can go on to the brain and have nasal involvement. There have been some reports of pulmonary mucormycosis.

According to the West Bengal Health Department’s advisory titled ‘Mucormycosis – if uncared for – may turn fatal’, the warning signs of the disease include pain and redness around eyes or nose, fever, headache, coughing and shortness of breath along with vomiting blood and ‘altered mental status’ – general changes in brain function like confusion, amnesia, loss of alertness and disorientation.

The suspected signs according to the advisory are nasal blockade or congestion, one-sided facial pain, numbness, blackish discolouration over bridge of nose or palate, toothache, loosening of teeth, blurred vision along with chest pain and worsening of respiratory symptoms.

At present the anti-fungal drug Amphotericin-B is being used to treat black fungus.