“Mucormycosis or Black Fungus”
Mucormycosis, known as “Black Fungus,” is a fungal infection that results in the
nose becoming blackened or discolored. Other symptoms include blurred or double
vision, chest pain, breathing difficulties and coughing up blood. Recently, it has caused
over 2,100 deaths among COVID-19 patients in India, and over 11,000 confirmed
cases. The disease, which is usually quite rare, has a mortality rate of around 54 per
cent, according to the US Centers for Disease Control and Prevention. This rate is
contingent on the condition of the patients’ health, as well as the body parts affected.
Without immediate treatment using anti fungal medication and surgery to remove
ensuing necrotic tissue, mucormycosis can easily be fatal.
The infection is closely linked to diabetes, and other conditions that cause the
immune system to be compromised. Some experts believe that the overuse of certain
immune system suppressing drugs could be behind India’s recent surge. An example
of this is the steroid dexamethasone, which is used by intensive care doctors. One
myth surrounding the fungal infection is that it is contagious, which it is not. It can not
be spread from human to human contact, or human to animal contact. It can spread
from fungal spores present in the air or environment, which are practically impossible
The ensuing infection will then rapidly spread from the nose and sinuses to the
face, jaw, eyes and even brain. The fungus blocks blood flow, killing infected tissue. It
is then this dead, or necrotic tissue that results in the characteristic black discoloration
of people’s skin. One professor, Malcolm Richardson, who is a professor of medical
mycology at the University of Manchester in the United Kingdom, believes the name to
be “totally inappropriate.” He shares this because the actual fungus is transparent, not
Generally, our immune system is able to fight off this particular fungi, but when
paired with diabetes, COVID-19, and steroid treatment, a person’s immunity can be
weakened to the point that these microorganisms can gain some traction.
Some experts believe that the unsanitary conditions at some hospitals in India
could heighten the risk of developing the infection. An ophthalmologist at Hinduja
Hospital in Mumbai named Nishant Kumar is quoted as saying, “There is a lot of
contamination in the pipes used for oxygen, the cylinders that are being used, the
humidifiers used.” He continues by saying, “If you are immuno-suppressed, and you
have been on these pipes and oxygens for a long period of time, then these infections
get much more of an opportunity to get in.” Strangely, other doctors and scientists do
not agree with Dr. Kumar and consider this to be a myth, as black fungus cannot
produce spores in fluid, and there is no evidence backing this.
Older studies on the infection that were published in 2014 and 2016 implicated
hospital linens from poorly managed laundries as a source of the fungus spreading.
Another 2009 review that researches hospital outbreaks list wooden tongue
depressors, adhesive bandages, ostomy bags, and ventilation systems. One report
from the University of Kentucky in Lexington believes that another route of
transmission is the inhalation of spores that travel by dust from nearby buildings that
may be under construction, or contaminated air-conditioning filters.
Opinions between experts are divided, however. SP Kalantri, who is a senior
doctor and researcher at the Mahatma Gandhi Institute of Medical Sciences in
Maharashtra has said, “Hospitals were dirty even before April. We need
epidemiological studies to assess why these cases are rising now.” It’s important to
also note that even before the pandemic, the prevalence of mucomycosis may have
been around 70 times higher in India in comparison to the rest of the world.
One systematic review that took place in 2021 looked at all COVID-19-related
cases of black fungus published in one scientific literature. Dr. Awadhesh Kumar Singh
and his co-authors discovered 101 cases, with 82 of them in India and 19 from the rest
of the world. Among the aforementioned cases, 31 per cent resulted in a fatality. The
authors also reported that around 60 per cent of all the cases were actively infected
with COVID-19, while 40 per cent happened post recovery.
Several myths surround the fungal infection, two we have already mentioned.
Another myth is that face masks can harbor black fungus. There is no evidence
pointing to this. The last myth is that onions are to blame for the fungal infection. Again,
a misattribution purported through social media. Possibly the most harmful myth is a
video circling social media that claims a concoction of mustard oil, potash alum, rock
salt, and turmeric can cure mucormycosis. However, as mentioned previously, the only
treatments that are proven to work is surgery performed to remove necrotic tissue,
along with the antifungal drug called amphotericin B. This has now ended in severe
shortages of the drug in India.
Currently, there hasn’t been any news coverage on black fungus infection being
discovered in America. Some tips to avoid possible exposure is wearing protective
gear such as a mask when visiting dusty construction sites, along with long sleeved
shirts and long pants. The Outlook India website is also urging people to wear gloves
while handling garden soil, moss, or manure. Practicing good personal hygiene habits
is always necessary, and calling a doctor in case any symptoms occur.