Bangladesh reports maiden black fungus case

Bangladesh Tuesday officially reported its maiden case of mucormycosis, or black fungus – a rare fungal infection to which recovering and recovered Covid-19 patients with compromised immune systems are more susceptible.

The patient has been undergoing treatment in Dhaka's Birdem General Hospital. The 53-year-old man from Bangladesh's south-western district Satkhira recently recovered from Covid-19.

Doctors suspect that another 65-year-old person who died three days ago at the same hospital might have been infected by black fungus.

Professor Dr M Delwar Hossain, head of Respiratory Medicine Department at Birdem Hospital, said, "We are almost confirmed about the infection of the patient who is now undergoing treatment here.

"Another person who died three days ago might have also developed the fungal infection. The initial reports support our suspicion, though we are not sure yet. We will be certain after receiving the test reports of the deceased."

What is the black fungus and how to combat it?

Prof Delwar said the deceased got infected by coronavirus, had uncontrolled diabetes and kidney complications.

The patient who is undergoing treatment also has diabetes.

But neither the deceased, nor the patient had any travel history to India – where more than 8,800 cases of the deadly fungal infection have been detected so far amid the Covid-19-led health catastrophes.

Professor Delwar said the condition of the person admitted to Birdem Hospital was not critical.

With Covid-19, the person was admitted to Khulna Medical College Hospital. He was subsequently discharged as he recovered. But with fever, he recently came to the hospital and then shifted to Birdem.

In recent months, India saw thousands of cases affecting recovered and recovering Covid-19 patients. More than 250 have died because of the disease, reports Aljazeera.

Doctors say there is a link with the steroids used to treat Covid. Diabetics are at particular risk. Doctors have told the BBC it seems to strike 12 to 18 days after recovery from Covid.

But Prof Delwar says there is no need to panic about black fungus.

"Both our surroundings and human body have the presence of black fungus. But when the immune system weakens, then it turns into a disease. Especially those with uncontrolled diabetes have a higher risk. People who take steroids are also at risk of fungal infection," he noted.

What are the symptoms?

Pain and redness around the eyes and nose, a fever, headache, coughing, diarrhoea, black and bloody nasal discharge are the common symptoms of the infection.

Moreover, patients may feel pain on one side of the face and in the sinuses, blackish discolouration over the nose, tooth pain, and painful and blurred vision as the symptoms of the fungal infection, according to The Guardian.

Is the black fungus contagious?

The disease is not infectious, which means it cannot be passed from person to person or animal to animal. However, it is transmitted by fungal spores in the air or in the environment, which are almost difficult to prevent.

Data from the US Centers for Disease Control and Prevention (CDC) show that mucormycosis has a mortality rate of 54%, which can vary depending on the condition of the patients and the body part affected.

The underlying cause of the disease in India, according to a Firstpost report, is the unsanitary way of supplying oxygen to patients in many areas, coupled with the indiscriminate use of steroids in the treatment of Covid-19.

Avoid indiscriminate use of steroids: Experts

Doctors said patients with diabetes, cancer, taking chemotherapy for cancer or any immunocompromised person can be infected with black fungus. They advocated for being more cautious in steroid and other life-saving drug usages for Covid-19 treatment.

Dr Forhad Uddin Hasan Chowdhury, registrar of the internal medicine department of Dhaka Medical College Hospital, said recovering coronavirus patients with weaker immune systems are more susceptible to the fungal infection. The use of steroids and tocilizumab often led to weaker immunity.

He said many hospitals use steroids for Covid-19 patients in the first week of infection, which is not right.

"Steroids can only be used only for severe cases in the second week," he said, adding, doctors need to be more careful about the timing, dose and duration of steroid use.

"The blood sugar level of Covid-19 patients should be monitored regularly as steroids often lead to uncontrolled sugar levels."

Dr Forhad also talked about maintaining proper hygiene while providing respiratory support.

Professor Nazrul Islam, noted virologist and a member of the National Technical Advisory Committee on Covid-19, said black fungus amid the pandemic is concerning.

Echoing Dr Forhad on steroid use and keeping blood sugar under control, he stressed on wearing a clean face mask, maintaining hygiene and cleanliness at hospitals.

Don't get panicked: Minister

Health Minister Zahid Maleque has urged people not to panic.

"There is no need to panic over the black fungus. It can be prevented through awareness," the minister said at Dhaka Medical College Hospital on Tuesday.

He said the government is taking emergency measures to tackle the black fungus. The health directorate will provide a treatment guideline for the black fungus patients.

"For precautionary measures, the country's pharmaceutical companies have been asked to increase production of antifungal drugs," Zahid Maleque said.

Besides, departments concerned have also been instructed to provide proper treatment for the disease, he added.