In the midst of COVID pandemic, India is battling a surge of ‘black fungus’

India, already in the midst of a catastrophic wave of COVID-19 infections, is now facing a dual health crisis: dangerous “black fungus” infections developing in recovered patients’ brains.

Even prior to the pandemic, the rare fungal infection disproportionately affected Indian patients, with the prevalence of the infection estimated to be about 70 times higher in India than the rest of the world.

But University of Queensland professor of medicine Paul Griffin said COVID-19 “tipped the balance” in the favour of the disease.

“With the germ there in the background, it’s inevitable in a lot of ways we will see more cases [of mucormycosis] reported in India,” he said.

What is mucormycosis?

Mucormycosis is a fungal infection caused by a group of moulds called mucormycetes, found in soil and in decaying vegetation.

The infection affects the sinuses, brain, lungs, skin and kidneys, and symptoms depends on where in the body the fungi is growing.

Most commonly, patients present with a blocked nose and sinus pain, but they often also get a headache and fever.

People can lose their sight if the eye socket becomes infected, and the infection can spread to the brain, causing seizures, coma and comprehension difficulties.

With patients who get the infection on their skin, mucormycosis can look like blisters or ulcers, and the skin may turn black.

Julie Djordjevic, head of the fungal pathogenesis group at the Westmead Institute for Medical Research, described the fungi as “nature’s decayer”.

“Their job is to break down organic matter; if they weren’t there, there wouldn’t be a world as we know it,” she said.

“And they’re very effective at replicating themselves.

“They make spores which are very airborne and they can produce billions of them.”

People can get sick if they breathe in or eat some types of spores from the environment, but they can also enter the body through a cut or broken skin.

‘Easy to diagnose’ but treatment is expensive

Professor Griffin said in countries such as Australia, doctors would be able to recognise and diagnose the infection early.

And now that it’s been identified as an issue, Professor Griffin said Indian doctors would likely be on the lookout for symptoms.

“It’s easy to diagnose with invasive tests,” he said.

“But not all countries have access to the antifungal treatments needed to treat it.”

Those antifungal treatments include amphotericin B and isavuconazole, but they’re often expensive, according to Professor Griffin.

And specialists often need access to a microbiology lab to help with a diagnosis — facilities that are already stretched to the limit with COVID-19.

But while it’s not likely this disease will be an issue in Australia, Professor Griffin has urged people to get vaccinated when they can.

“If we stay on top of COVID, this type of infection won’t ever be seen here,” he said.

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