Black fungus in Delhi: Are Mucormycosis cases declining? Senior doctor has this to say

The Sir Ganga Hospital in Delhi is not getting any active cases of mucormycosis infection anymore, said senior doctor Ajay Swaroop, who heads the ENT department, on Friday. 

Speaking to news agency ANI, Swaroop said that only those who had mucormycosis previously were coming to the hospital now. 

"We're not getting any active cases. What we are seeing now is old cases that either have residual disease or patients who had a disease which was treated and now they’ve developed mucormycosis,” the doctor said. 

“We are now seeing such kinds of cases and also receiving patients from smaller centres. After suffering a lot, they moved out because transportation is now much easier. Fortunately, not a single case is active,” he added.

Speaking about the cause of recurring infection, he said it could be because of three reasons. 

“This could be because they have not taken a full medicinal course, or because they did not return for post-operative follow-ups which resulted in the fungus growing up again. It is also possible that from the nose or sinuses, the infection has shifted or moved to other sides."

Mucormycosis, caused by fungi known as mucormycetes, is also commonly known as black fungus. It had emerged as a common complication among those who have recovered from Covid-19 – a condition now termed Covid Associated Mucormycosis (CAM).

Although not a new disease, mucormycosis was not a notifiable disease till May 2021 when the Union ministry of health and family welfare requested states to declare it so under the Epidemic Disease Act, 1897 to get its objective assessment in the community.

When the prevalence of the disease first started increasing in 2020, several infectious disease specialists considered several hypotheses then. 

Some wondered if the oxygen administered to Covid patients, or the water in the humidifiers the oxygen passed through, was contaminated with Mucorales. Others wondered if the pandemic lockdowns led to diabetic patients not taking their drugs or exercising regularly, causing their blood sugars to spike.

Yet another suspect was treatment with corticosteroids (steroids), again a known risk factor for mucormycosis in pre-pandemic times. Finally, some hypothesized that covid itself was making people vulnerable to mucormycosis, steroids or not.

Out of this bouquet of possibilities, the strongest, so far, is the steroid hypothesis: i.e that steroids were the biggest novel factor in 2020 and 2021 which sent mucormycosis cases soaring to historic highs.