Black Fungus is deadly but not contagious, certain patients need to be extra careful: Dr Asif Ahmad Wani 

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As Jammu and Kashmir is battling with COVID19 infection that has claimed more than 3422 lives, the region has recorded at least 4 confirmed deaths due to Black Fungus (mucormycosis) since last year. The recent one was recorded on Friday at a Jammu hospital. The emergence of cases has added to the worries of people as the disease is deadly, having more than 60% mortality rate. Dr Asif Ahmad Wani, Head of Department ENT and Head & Neck Surgery Sher-i-Kashmir Institute of Medical Sciences, Medical College Srinagar explains the emergence, symptoms, precautions and treatment of the fungal infection.

Below are the excerpts of his interview with The Kashmir walla

TKW: What is Black Fungus and who gets infected?

Dr Asif Wani: Other than COVID19, Black Fungus is much talked about these days but the difference between the two is that COVID was a novel disease when it broke out in India last year and Black Fungus (mucormycosis) has been present here.

But there is a low percentage of people infected by the disease and we can say that it is a rare disease. It is a fact that we are surrounded with the Fungus and (they are) even found inside our body. There is nothing to worry about the presence of fungus but it waits for an opportunity to strike as it is known as opportunistic infection.

It affects the people with weak immune systems and mostly affects diabetic patients whose disease is not under control.

TKW: Who are the people whose immunity is weak and what kind of people are prone to the infection?

Dr Asif Wani: The infection overpowers people with diabetic disorder and among them it only attacks those who fail to get proper treatment or have fairly advanced disease. People who have immunosuppression are prone to the disease. The infection primarily finds its way in Rhinocerebral and if the person has a strong immune system it overpowers the infection, else it turns into a disease. Patients whose organs have been transplanted have weak immune systems as they are administered immune suppression drugs. It is deliberately given to avoid the rejection of the transplanted part by one’s immune system. Patients having serious burn injuries or malignancies like cancer – leukemia, lymphoma wherein blood cells get destroyed are prone to it as immunity comes from blood cells. Patients having kidney failure or liver failure have weak immunity that may result in overpowering by Black Fungus.

TKW: Which parts of the body are mostly affected by the Balck Fungus?

Dr Asif Wani: It mainly affects Rhinocerebrum – paranasal sinuses, nose, eyes, brain and and can also affect, chest, lungs (pulmonary mucormycosis), gastrointestinal tract, skin. In patients with extremely weak immune system there are chances of disseminated mucormycosis, where more than one part of the body gets infected by the fungus

TKW: What are its symptoms?

Dr Asif Wani: During the primary phase, a person infected with Black fFungus would start feeling cold, itching, and irritation. We must keep a high level of suspicion if we feel anything like this as it spreads so quickly in immunocompromised patients. Once we fail to immediately find it out, it attacks our blood vessels and the area that has been receiving blood supply through those vessels face shortage of supply and ultimately turn dead. The infection is harsh and powerful.

Once a person gets involved in case the infection finds its place in Rhinocerebral he gets headache, pain behind eye, swelling, bleeding, black clots. In the advanced phase of the disease, the patient loses memory, vomits, has poor or deficient color vision, faces problems in movement etc.

What is the treatment?

Dr Asif Wani: The infection is diagnosed through Biopsy and CT Scan to find out the destruction caused. Treatment has to be prompt and vigorous concerning the severity of the disease. The moment one has suspicion of it, he/she should immediately get treatment. There are only two treatments i.e. supportive treatment in which antifungal medicines are administered to the patient, and the surgical treatment. In surgical treatment the infected part is removed and there are more chances of disfigurement. As in the surgery procedure we do have to ensure that the infected part is removed along with healthy tissues bordering the infected part regardless of its importance in the body. It has a high mortality rate.

TKW: At what stage a patient with the Black Fungus infection could be saved?

Dr Asif Wani: It is to be treated at the very initial stage as there are some chances of saving the patient only if the small and less important part of the body is infected.

TKW: Is it anyway related to COVID19?

Dr Asif Wani: As to treat COVID19, steroids are used to treat patients that result in suppression of the immune system. We cannot rule out use of steroids as it has been very helpful and is undisputed in treatment of COVID19 patients but should be used judiciously under the medical supervision else it may have a negative impact on the health of a patient. When patients with comorbidities are administered COVID19 drugs, they become immunocompromised and at that stage they become prone to the fungal infection (mucormycosis). However, it is not contagious but depends on one’s immunity.

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