‘Nothing new, don’t panic’: Fungal attack in viral times

A disconcerting situation has come to define a new dreadful disease during pandemic in Kashmir.

The staggering case first surfaced in the late fall of 2020 — the season of thaw when the coronavirus had supposedly lost its sting, if not venom, in the valley.

But the medical task force wary of ‘probing press’ conveniently concealed the case reportedly stemming from Kashmir’s southern pocket.

However, months later, the hushed case resurrected after a Jammuite followed by a Srinagarite was diagnosed with black fungus in the second viral wave.

But while the suspense and silence prevails over the first case history, the assertion of chest specialist Dr. Naveed Nazir cleared some airs about the disease lately: “As per HoD Oral & Maxillofacial surgery GDC Srinagar they have already successfully operated one case of mucormycosis in Nov 2020 and another strong suspect case admitted with them.. both post covid and diabetics.”

In the challenging times when inescapable horrors are turning real by the deadly Covid, mutant variants and uncertainty of the third wave, black fungus has only come as another challenge.

Days after the top doctor’s tweet, Free Press Kashmir got in touch with Maxillofacial surgeons of Government Dental College (GDC), Srinagar for the case investigation.

But just then, another official summon had silenced the medical camp’s media briefing. However, one of them agreed to share details off the record.

Confirming the veracity of the first strong suspect of Black Fungus in GDC Srinagar on May 23, a senior surgeon in the Oral Maxillofacial department said the 54-year-old man from Srinagar’s Habba Kadal area is now shifted to the ENT department of GMC Srinagar for biopsy after the provisional diagnosis.

“Both of the cases, the one we acknowledged last year and the recent one whom we shifted to ENT, were maxillofacial cases where the soft palate of the mouth was infected as the host,” the surgeon made it short.

The new case surfaced when many doctors—including the two vocal fronts operating under one name—blamed steroid prescription for black fungus cases in the region.

During the Covid treatment, steroids are given to severe patients for treating inflammation against the virus.

“But at the same time,” Dr. Rouf, a microbiologist at Kashmir University, told FPK, “it also represses the immune system by killing and decreasing the count level of our first-line barriers, like lymphocytes.”

After the blood count is decreased, the microbiologist says, the steroid also increases the blood sugar level which is fatal to an already diabetic patient. “Higher blood sugar levels increase the acidic condition providing an environment for the funguses to prevail.”

Since coronavirus weakens the immune system, Black Fungus or Mucormycosis is mostly reported among recovering and recovered Covid patients. It also makes a certain population vulnerable due to their homemade remedy habits.

Since many people in Kashmir are presently using stream inhalation to ward off the ongoing flu season, a recent study has shown that excessive use of steam inhalation can damage the delicate mucus layer “making it easy for the fungus to breach our natural defence”.

These telling revelations about Black Fungus are coming at a time when a horrible image of a 40-year-old Poonch man is making rounds on the social media. The graphic details, along with the reported removal of afflicted body parts, have created a sense of panic.

“But people should not panic,” a senior Kashmiri doctor told FPK. “The black fungus has a death rate of 1.6% per thousand cases.”

However, after it claimed its victims from J&K—one from Poonch and another from Kathua—Black Fungus was declared as the epidemic by the J&K government under Section 2 of the Epidemic Disease Act 1897.

“Since Black Fungus is found in air and soil, it only enters the human body when spores are inhaled, but it’s not contagious and communicable like coronavirus,” microbiologist Dr Rouf continued.

The severity arises when body parts like nasal plate, skull and brain gets infected as host, he said.

“The infection blocks the arteries due to which tissues don’t get the oxygen. To prevent the infection from reaching the brain which can lead to sudden death, we remove necrosis of the tissues or body organ to save the patient.”

But despite creating another dread in pandemic, virologists say black fungus is not something new—as comorbidities and unhygienic intervention are known to ignite the rare blaze.

“It’s an opportunistic infection which means it takes an opportunity to host human skin,” virologist Dr Ruqaiyah Nazeer told FPK.

“But if there’s a rapid black fungus rise in India it’s because the country has the second largest diabetic population.”

To combat the problem, the virologist says, there must be proper medical care over the usage of steroids, timing schedule and retention period.

“Besides we all should change our masks very frequently, as most of the funguses take time to grow than the bacterial infections,” Dr. Ruqaiyah says.

“Using the same mask over longer period forms dampness creating a home for the fungal infection. If all the hygienic protocols would be maintained, we could stop black fungus to become another never-ending pandemic.”


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