How Dangerous is Dreaded ‘Black Fungus’?
By Dilanthi Jayamanne
Remember the fear that gripped Sri Lanka and the scary stories that were aired over radio and television channels earlier this year when the ‘black fungus’ was detected from COVID-19 patients in India? Our giant neighbour, who was going through a traumatic period with people succumbing by the thousands to the deadly COVID-19 delta wave was also victim to the deadly black fungus – Mucormycosis, which is said to have maimed closed to 45,000 people in that country. According to news reports from India at the time, Mucormycosis affected the eyes, nose and the brain of those recovering from the coronavirus.
Indian doctors at the time said that the fungus was linked with the steroids used to treat COVID-19, and that diabetics were at particular risk. The steroids that were given not only to reduce inflammation in the lungs caused by the viral infection but to also help stop some of the damage when the body’s immune system went into overdrive to fight virus. Unfortunately, they also reduce immunity and upped the blood sugar levels in both diabetics and nondiabetic COVID-19 patients. This drop in immunity could be the trigger of Mucormycosis in diabetics or severely immunocompromised persons, such as those with cancer or human immunodeficiency virus/ Acquired Immuno Deficiency Syndrome (HIV/AIDS).
At the same time a case was said to have been detected in May this year in Ampara. Locals were gripped by fear by the possibility that the fungus would affect COVID patients in Sri Lanka which was experiencing the Alpha strain of the virus at the time. Therefore, the possibility of having to deal with another monster disease in which one could lose an eye or another part of the anatomy was beyond imagination. But the fears were doused at the time by the Health Ministry and Specialists and Consultant Mycologist from the Medical Research Institute, Dr. Primali Jayasekera.
She said that the country had seen about 24 people infected with Mucormycosis or the Black Fungus this year but that they had tested negative for the coronavirus. Additionally, till now the country has only seen 13 Black Fungus cases infected with COVID 19 this year. The first post COVID-19 patient infected with Mucormycosis being detected in June 2021. In 2019 the island had recorded 42 patients with Mucormycosis and in 2020 there had been 24.
“Black Fungus is not something new to Sri Lanka, as the country has a conducive environment for its formation,” she explained. The best prevention would be proper hygiene practices. Deputy Director General Disaster Management and Emergency Response, Dr. Hemantha Herath reassured the public that the fungus was non-communicable when Mucormycosis resurfaced this month.
At a Media briefing, he said that that several cases had been detected at the National Hospital, Colombo, Teaching Hospitals Kurunegala and Ratnapura and a few other hospitals. Those with low immune systems and those who were taking immune suppressant medication were among the most vulnerable than the healthy. People with uncontrolled diabetes, who are on chemotherapy drugs, patients with blood cancers and who have undergone organ transplant surgery were amongst this highly vulnerable groups.
Added burden named Aspergillosis
In the wake of the Black Fungus the Sri Lankan public have been warned of other fungal infections. This is due to airborne fungi that can infect immuno-compromised COVID -19 and post COVID-19 patients. Harking back to school science lessons, students know that Aspergillus fungi could be seriously damaging to patients who have reached the stage of COVID Pneumonia. Having been taught that Aspergillus, the mold which is a type of fungus that causes aspergillosis, is said to be very common both indoors and outdoors, so much so that people breathe in fungal spores every day.
Aspergillosis is an infection caused by Aspergillus species. But the best part probably is that most people breathe in Aspergillus spores daily without falling ill. “Although not as fearsome as the Black Fungus it could be more worrisome once the Aspergillus fungus starts to colonise within the lungs. It would later start spreading and eventually cause problems,” she said.
Such patients are the ones who have suffered COVID pneumonia.” The most critical condition of the infection was the damage it could cause to the lungs, Dr. Jayasekera said. Till now there had been more than 700 patients with COVID associated pulmonary Aspergillosis. There is a test which needs to be performed in order to diagnose fungal infection as it is an invasive mold that a patient who has gone through the COVID pneumonia stage may suffer.
Dr. Jayasekera said that the treatment required for these extreme cases of COVID Pneumonia who have been infected by Aspergillosis is available in Sri Lanka and is also locally manufactured.