Doctors in Bangladesh on Tuesday rushed in a meeting to formulate guidelines for the management of ‘black fungus’ disease along with Covid-19 following the death of a patient at Birdem Hospital in Dhaka.
Health Minister Zahid Maleque, however, urged people not to be panicked as the disease can be prevented. He also asked pharmaceutical companies to keep medicines ready.
The life-saving drug ‘liposomal amphotericin b’ cannot be produced in the country, Professor of Medicine Dr Khan Abul Kalam Azad told Bangladesh Post.
Black fungus, medically known as Mucormycosis, is a very rare infection. With the rise of Covid-19 cases, it has become widespread in different states of neighbouring India.
Prof Delwar Hossain, head of the Respiratory Medicine Department of the Birdem Hospital told journalists that they found the symptoms in two Covid-19 patients. “One died three days back,” he said on Tuesday.
The IEDCR has collected samples for confirming his black fungus, Dr ASM Alamgir, Principal Scientific Officer of the government’s disease monitoring agency, told Bangladesh Post.
Prof Azad, who retired from the Dhaka Medical College Hospital, the busiest hospital in the country, told Bangladesh Post that he had never seen black fungus cases in Bangladesh.
“But it was always there in India. Estimates suggest it affects an estimated 14 in every 100,000 people in India,” he said.
According to the US Centers for Disease Control and Prevention, Mucormycosis (previously called Zygomycosis) is a serious but rare fungal infection caused by a group of molds called Mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or other type of skin injury.
It has been seen in countries like India and China, particularly among patients suffering from diabetes, cancer, or immune compromising conditions like HIV AIDS.
Now, survivors — especially those having co-morbid health issues like diabetes, heart and kidney ailments and cancer — have been found to be susceptible to the disease.
Till 22 May, India has reported about 8,848 cases of black fungus or Mucormycosis, according to a statement by Union minister Sadananda Gowda.
“Our doctors are on alert. So far, we did not find any cases at DMCH, Suhrawardhy Medical College Hospital and Mughda Medical College Hospital, three big Covid-19 dedicated facilities in Bangladesh,” said Prof Azad.
According to an article in Firstpost, the underlying cause of the disease in India is the unhygienic way of delivering oxygen to patients in many places, combined with the indiscriminate use of steroids in the treatment of COVID.
Prof Azad said with the rising cases in India, patients with Covid-19 were being treated anywhere due to shortage of beds and hospital facilities.
Besides, animal excreta such as cow dung can spread the disease. “We have seen many photos and videos that in different parts of India people are smearing cow dung on their bodies to prevent Covid-19,” he said.
He said the disease can be fatal if it enters the body through sinuses, such as hollow spaces behind the face. Through those sinuses, it can go into the brain.
It is called Rhinocerebral (sinus and brain) Mucormycosis. The symptoms include one-sided facial swelling, headache, nasal or sinus congestion, black lesions on nasal bridge or upper inside of mouth that quickly become more severe and fever.
The symptoms of black fungus are pain and stuffiness in the nose, inflammation on cheeks, fungus patch inside the mouth and swelling in the eyelids.
People have been asked to see doctors in case of symptoms.
However, it cannot spread from one person to another. Director of India’s AIIMS Dr Randeep Guleria was quoted as saying in Indian media: “It is not contagious. Low immunity leads to black fungus. About 90-95% of cases have diabetes and have been given steroids.”
“While black fungus is not contagious, it does spread from fungal spores present in the air or in the environment. But it needs to be understood that there are fungi as well as bacteria present in our bodies but they are kept under control by our body’s immune system. When the immune system is compromised due to irrational use of steroids, diabetes, cancer treatment, it allows these bacteria and fungi a chance to multiply and spread infection,” the director said.
Prof Azad, who is also a member of the clinical management committee on Covid-19, said they would finalise the black fungus management guidelines soon. “But we have already suggested a few measures to prevent it.”
Those include changing water in the oxygen cylinder, keeping the hospital environment clean, maintaining distance between patients, avoiding rotten foods, and strengthening laboratory support.
The disease seems to strike 12 to 18 days after recovery from Covid-19, according to doctors in India.