Covid-19: Is mucormycosis contagious?

In the second wave of Covid-19 in India, the country has witnessed a sudden surge in the number of mucormycosis cases. The infection that’s causing people to go blind has been categorised as an epidemic in several states.

There are a lot of questions about this rapidly spreading infection and we've put together some answers:

What causes mucormycosis?

Mucormycosis, also known as 'black fungus', is an infection caused by a group of fungi called mucormycetes. It's also called black fungus infection because it's characterised by black nasal discharges and black patches of skin around the nose in the initial stages. These fungi can be easily found in our surroundings like soil, compost piles, leaves, cow dung.

Also read — DH Deciphers | Mucormycosis or 'black fungus': A double whammy for Covid-19 patients?

How does mucormycosis spread?

Mucormycosis is not contagious, and it cannot spread from people and animals. However, one can get infected by 'black fungus' through inhalation, inoculation or ingestion of the fungal spores. It can also spread through bandages, linen, unsterilised water, poor air filtration, non-sterile instruments and open wounds.

“Mucormycosis can spread through the air. It won’t cause any problem if a person is healthy. Mucormycosis may enter into the lungs but the chances are very low. Our body is capable to fight it if the immunity is strong,” said Dr Nikhil Tandon, Prof and Head of Department of Endocrinology and Metabolism, AIIMS, Delhi told ANI.

When the fungal spores are inhaled, they infect the lungs or sinus. If it enters through a skin cut or any other open wound it spreads on the skin. Slowly, the infection spreads into the blood and reaches the brain, heart, and spleen.

In all, mucormycosis is not a communicable disease like Covid-19, it doesn’t spread from one person to another, Dr Randeep Guleria, AIIMS Director told The Hindu.

How can you avoid getting infected?

People with low immunity are more likely to get infected from mucormycosis and it can be life-threatening for them. Hence, it is advisable for them to wear masks in construction sites and be fully clothed with gloves and shoes while gardening.

Maintaining personal hygiene is of the utmost importance. After coming from outside, one should take a thorough scrub bath. A News18 report quoted Dr Suresh Kumar, medical director of Delhi’s LNJP Hospital, saying, “Fungus grows in cramped and humid spaces so ensure that your surroundings are cleaned regularly. Avoid consuming eatables refrigerated for days, eat fresh fruits, let sunlight in your house, and wash your masks daily.”

According to Dr Randeep Guleria, diabetic people need to control their blood sugar level and people should take steroid only under medical supervision to avoid any serious complications if got infected by black fungus.

“Steroid use has become much more in second Covid-19 wave, and steroids given when not indicated in mild or early disease can cause a secondary infection. Those given high dose of steroids when not indicated can lead to high blood sugar levels and a high chance of mucormycosis," Guleria told News18.

How can we detect mucormycosis?

Initial-stage symptoms include sinus headache, facial pain, stuffy nose, nasal bleeding, blurring of vision, double vision, dental pain, tooth pain and loosening of teeth. Later symptoms are one-sided facial swelling, skin colouration, Ptosis (closure of eyelids), Proptosis (swelling of the eyeballs), restricted eye movements, palatal blackish discolouration and brownish nasal discharge.

Mucormycosis is diagnosed through a range of blood tests and scans, including complete blood count, blood sugar test, renal function test, deep nasal swab, KOH staining to detect the fungus, nasal endoscopy and biopsy, MRI of the brain, CT scan of the nose and paranasal sinuses.

What is the treatment?

Early diagnosis of the disease is key to minimising the damage. The treatment might continue for four to six weeks. Mucormycosis is treated with antifungal medication, injection of liposomal amphotericin B, surgical debridement, controlling blood sugar, discontinuing immunomodulating drugs, etc.