As black fungus cases are being reported in the country particularly in COVID patients, some medical experts feel that "unhygienic masks" and poorly ventilated rooms could be a contributing factor, while others opine that there is "no clinical evidence" established so far linking the two.
Doctors at many leading hospitals in Delhi said many patients, both COVID and non-COVID, have been infected with mucormycosis or black fungus and had a history of exhibiting poor hygienic practices, including wearing unwashed masks for a long time.
According to Dr Suresh Singh Naruka, senior consultant, ENT at Indraprastha Apollo Hospitals, "irrational use of steroids" is the primary course of the disease while unhygienic practices like wearing masks over a long time without washing them, or staying in poorly ventilated rooms such as a basement, or less airy rooms are second factors which could be a trigger point for contractor mucormycosis.
However, Mucormycosis is more common among people whose immunity has lowered due to COVID, diabetes, kidney disease, liver or cardiac disorders, age-related issues, or those on medication for auto-immune diseases like rheumatoid arthritis.
As these patients are administered steroids, their immunity is low allowing the fungus to thrive in their body.
"In many cases, we also found that people who had contracted black fungus had self-medicated themselves on steroids, after their oxygen concentration levels had dropped, making them susceptible to this ailment which is being found more in COVID patients under treatment or recovery than others," Naruka said.
Meanwhile, Delhi Chief Minister Arvind Kejriwal on Thursday said dedicated centres will be set up for the treatment of black fungus or mucormycosis cases at three city government-run hospitals.
"Three important decisions were taken at the meeting. Centres will be set up at Lok Nayak Jai Prakash Narayan Hospital, Guru Tegh Bahadur Hospital and Rajiv Gandhi Super Speciality Hospital for treatment of black fungus," the CM tweeted.
Dr Ajay Swaroop, chairman of the ENT department at Sir Ganga Ram Hospital here, said, mucors live in every human body along our nasal passage and the nasopharyngeal region "symbiotically".
"It is when a person's immunity is lowered, as in the case of COVID, that these mucors start growing and cause infection. The red flags are nasal discharge with bloodstains, swelling in the nose of the eye," he said.
At Sir Ganga Ram Hospital, 60 cases of black fungus have been reported to date since the rise in coronavirus cases. Twelve of them are COVID-positive ones, and the rest post-COVID cases, within 2-3 weeks of their recovery period, Swaroop added.
Again, when asked if unhygienic masks could trigger black fungus, he said, "There is no clinical evidence yet, to establish the link between the two".
Since the outbreak of the pandemic last year, health and administrative authorities have been emphasising seeking compliance of wearing of a mask and other COVID-appropriate behaviour.
"People are afraid of contracting the virus, so many of them keep on wearing the same mask, over and over again without washing, and that runs the risk of contracting the infection, as fungus will grow in moist or unhygienic areas," Naruka of Apollo hospital said.
Masks should be ideally washed after a person returns home from outside every time, just in hot water or some disinfectant or cleansed with a sanitiser at least.
A senior doctor at LNJP Hospital said just a couple of patients with black fungus are there at the hospital. However, they are being isolated as much as possible from the regular COVID patients.
Asked if the mask hygiene factor triggered the infection, the doctor said nothing conclusive can be said yet.
( With agency inputs )