Black fungus: Can you catch it from your fridge or stale onions?

There is a lot of panic across South East Asia about ‘black fungus’ or mucormycosis. It has caused substantial concern, morbidity, and even deaths of Covid-19 patients. This rare fungal infection has emerged at a time when many countries are reeling under the mounting cases of coronavirus. 

Unfortunately, as is the case with many unstudied infections, there are conversations about children catching this virus from refrigerators or even stale onions. 

We found out the reality of these rumours and if parents in Singapore should be worried. 

What is black fungus: What parents must know

According to the United States Centres for Disease Control and Prevention (CDC), mucormycosis is a serious but rare fungal infection caused by a group of moulds called mucormycetes.

Mucormycosis lives throughout the environment and mainly affects people with health problems or those who consume medicines that lower the body’s immunity.

These fungi live throughout the environment, particularly in soil and in decaying organic matter, such as leaves, compost piles, or rotten wood. 

You can get mucormycosis by coming in contact with the fungal spores in the environment. It can also develop on the skin after the fungus enters the skin through a cut, scrape, burn, or other types of skin trauma.

Now, five types of mucomycosis have been identified by CDC and fortunately, it hasn’t yet spread across to Singapore. 

5 types Of mucormycosis

• Pulmonary (lung) mucormycosis is the most common type in people with cancer and those who have had an organ transplant or a stem cell transplant.
• Rhinocerebral (sinus and brain) mucormycosis is an infection in the sinuses that can spread to the brain. This is extremely common in people with uncontrolled diabetes and in people who have had a kidney transplant. 
• Cutaneous (skin) mucormycosis occurs after the fungi enter the body through a break in the skin. It can be surgery a burn or any kind of skin trauma. This can happen even if you don’t have a weak immune system.
• Gastrointestinal mucormycosis is more common among young children than adults, especially premature and low birth weight infants less than one month of age. Especially those who have had antibiotics, surgery, or medications that lower the body’s ability to fight germs and sickness.
• Disseminated mucormycosis occurs when the infection spreads through the bloodstream to affect another part of the body. The infection mostly affects the brain, but can also affect other organs such as the spleen, heart, and skin.

Incidentally, a Twitter thread started by Dr Pramesh CS, director of Tata Memorial Hospital started an FAQ session wherein people asked several questions on what is black fungus and even myths surrounding it. 

[embed]https://twitter.com/cspramesh/status/1397494494870740996[/embed]

Here are some of the important takeaways from this thread discussion:

There is a lot of uncertainty about the origin of black fungus. As Dr Pramesh says, “The truth is that we don’t know everything about it, but let’s start by calling it what it is – 'mucor'. And anybody who claims that they know all about it is, let’s say, 'factually incorrect'.”

He then went on to answer more questions about this infection.  

1. How can you get infected with mucormycosis?

Most commonly, it is inhaled through the nose. Wearing a mask, therefore, helps prevent it.

2. Is mucor contagious?

No – you can’t get infected by being in close contact with someone else who has the disease.

3. Why are we seeing such an outbreak of mucor in India now?

Dr Pramesh cites that it can be due to a combination of reasons. The incidence of diabetes in India is quite high. Combine that with the widespread use of steroids in patients with Covid-19, with poor glucose control – this is a bad combination.

ALSO READ: 'Black fungus' complication adds to India's Covid woes

4. How can one reduce the chances of contracting mucor?

First, if you have diabetes, make sure your blood sugar levels are controlled. Uncontrolled diabetes is one of the strongest risk factors of infection from mucor.

Second, don’t use steroids unless prescribed by your doctor. Indiscriminate steroid use harms you in two ways – first, it reduces your immunity; second, it raises your blood sugar levels. Both of these predispose you to getting infected with mucor.

5. What are the symptoms of mucor?

Usually, the symptoms include swelling of one side of your face, a feeling of stuffed nose, headache, red eyes, blackening of the bridge of your nose or your palate, discharge from the nose, and fever.

When you develop these symptoms, do not try to manage this at home or self-medicate. Mucor requires urgent hospitalisation and treatment – please get admitted to a hospital.

6. Can we treat black fungus?

Mucor can be treated and cured if detected early and treatment instituted. Medical management includes amphotericin B, posaconazole, or isavuconazole. Some patients may require surgery. 

Dr Eric Cioe-Peña, director of global health at Northwell Health in New York, told Healthline, “Once it infects you, it’s very morbid and has a high mortality.” Depending on what part of the body is affected, mucormycosis can be fatal in up to 96 per cent of cases.

Now coming to the question of why are black fungus cases surging in India? 

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Experts said the cause is a combination of several factors. They may include contaminated oxygen equipment and the use of steroid drugs to treat certain Covid-19 patients.

They have further said that it is due to the poor preparation of the second wave of Covid-19, misinformation about the vaccine and relaxed restrictions that led to the current health emergency. 

As researchers are still trying to figure out what is black fungus, there’s a lot of misinformation surrounding the infection. Unverified claims about black fungus are being widely shared on social media sites. 

Let’s take a look at three such fake claims that have caught our attention. 

What is black fungus: Myths busted and fake claims debunked

Here’s a look at some fake claims getting viral on social media around the black fungus

Claim 1: Vegetables stored in your refrigerator can have black fungus.

Some claims on social media advise people to be careful of common use vegetables, including onions that could be a harbinger of black fungus infection. It further warns people that black grime can spread if used while cooking curries or stored in the refrigerator’s cool settings.

Truth: Not only is the claim completely untrue, but the mode of transmission for black fungus also isn’t through mere objects. 

Claim 2: Mucormycosis can be cured with alum, turmeric, rock salt and mustard oil. 

Truth: The Indian government's fact checking clarified in a tweet that this is fake.  It also warned the public not to rely on home remedies to cure diseases.

Claim 3: Stop eating chicken as they can spread mucormycosis to humans?

Truth: This is Fake. Mucormycosis cannot spread from humans to animals.

Dr Aparna Mukherjee, senior scientist at Indian Counsel for Medical Research (ICMR) said, “Mucormycosis is present throughout the environment, and so, it can probably infect chickens as well.

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''However, mucormycosis is not contagious, i.e. it cannot spread from contact between humans or animals. People are mostly infected by inhaling it through their noses and it is a drop in immunity that normally triggers cases of mucormycosis.”

Looking at the amount of fake news being circulated around black fungus, you must act responsibly. Always cross-check any fact before forwarding them to your network. Be aware of the symptoms and seek treatment at the earliest. 

As Dr Pramesh advises, “Mucor is better prevented than cured. Keep your blood sugar under control and avoid unnecessary use of steroids.” At the same time, follow Covid-19 guidelines strictly. Wear a mask, wash your hands and maintain social distancing always. 

Stay safe!

This article was first published in theAsianparent.