More than 4,300 people have died from the deadly “black mold” in India in a growing epidemic that mainly affects Covid-19 patients.
India has reported 45,374 cases of this rare and dangerous infection called mucormycosis, Health Minister Mansukh Mandaviya said.
It affects the nose, eyes and sometimes the brain and usually strikes 12-18 days after recovery from Covid.
Nearly half of those infected are still being treated.
Doctors say the fungus is linked to the steroids used to treat Covid, and diabetics are particularly at risk.
Steroids reduce inflammation in the lungs before Covid-19 and appear to help stop some of the damage that can occur when the body’s immune system overworks to fight off the coronavirus.
But they also reduce immunity and raise blood sugar levels in both diabetic and non-diabetic Covid-19 patients.
It is thought that this decline in immunity could trigger cases of mucormycosis in diabetics or severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS.
An antifungal shot is the only drug effective against the disease, doctors say.
The two worst affected states are Maharashtra and Gujarat, where 1,785 people have died from mucormycosis.
dr. Raghuraj Hegde, an eye surgeon from Bangalore who has treated a number of mucormycosis patients, told the BBC that there has been “massive undercounting of both cases and deaths” from the disease.
“Normally, deaths from mucormycosis occur weeks to months after getting the disease. Our current systems are not good at capturing that data,” he said.
The cases were also undervalued because diagnosis was difficult in smaller hospitals and in rural areas and only a fraction of cases reached hospitals in major cities, he added.
Doctors said many patients had died of the disease before reaching a hospital and a number of treated and recovered patients appeared to be suffering a relapse.
“We see patients who were treated aggressively for the disease and who were discharged from hospitals return with a recurrent infection that manifests as a wider spread of the disease in the eye or brain,” Dr. Akshay Nair, a Mumbai-based eye surgeon, to the BBC.
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