Fungal Infection Among COVID-19 Patients Explained: What Is Yellow Fungus?

Fungal Infection Among COVID-19 Patients Explained: What Is Yellow Fungus?

Mucormycosis that is being reported among COVID-19 patients and those who have recovered from it is not something new or specific to coronavirus and the colours – Black, White, Yellow are being used loosely to refer to the same infection affecting different body parts, say experts
Fungal Infection Among COVID-19 Patients Explained: What Is Yellow Fungus?Amid rising number of black fungus and white fungus infections in COVID-19 patients, a case of yellow fungus has been reported in. Here is all you need to know about it
Highlights
  • Terms like 'Black Fungus' and 'Yellow Fungus' can be misleading: Expert
  • Environmental moulds, unsanitary conditions cause infection: Dr Lahariya
  • Patients given steroids, antibiotics overdose are at high risk: Dr Narreddy

New Delhi: The second wave of the coronavirus pandemic is yet to subside, adding to the challenging times is the increasing cases of fungal infections among COVID-19 patient and those who recovered from it. Some states like Maharashtra, West Bengal, Tamil Nadu, Telangana, Rajasthan among others have declared fungal infection as a notifiable disease under the Epidemic Diseases Act, 1987. This means that whenever a case of fungal infection is diagnosed, it will have to be mandatorily notified to the respective district authority. While the country was already reporting many cases of ‘Black fungus’ among COVID cases, the recent reports of emergence of ‘White fungus’ and then a case of ‘Yellow fungus’ found in Uttar Pradesh, became a cause of concern. To learn about the recently reported ‘Yellow fungus’, NDTV spoke with Dr BP Tyagi, ENT (Ear, Nose, Throat) specialist, Columbia Asia Hospital in Ghaziabad, Uttar Pradesh; Dr Suneetha Narreddy, Infectious Disease Specialist, Apollo Health City, Hyderabad and Dr Chandrakant Lahariya, epidemiologist, public policy and health systems expert based in Delhi.

Also Read: COVID-19 And Black Fungus: Owing To Costs Of Treatment, Poor Families Stand Helpless While Centre Declares It Notifiable Disease

The First Case Of Yellow Fungus

While talking to NDTV, Dr Tyagi, who diagnosed the first case of yellow fungus in Ghaziabad, elaborated on the case. He said,

The 59-year-old patient who has been diagnosed with a case of yellow fungus is diabetic and had suffered from COVID-19, one month back. He was not on oxygen at all. When he was brought to the hospital, he was undergoing extreme fatigue, poor appetite with some blackish and yellowish discharges from nose. It was found that he was suffering from the case of all three- black fungus, white fungus and yellow fungus. Yellow fungus was denser and would take more time to heal.

He further said that unlike the two other infections, yellow fungus starts off internally, causes pus leakage, slow healing of wounds, and, in serious cases, can also cause devastating symptoms such as organ failure and acute necrosis (damage of tissues).

Does The Color Of Fungal Infection Matter?

Dr Narreddy and Dr Lahariya emphasised that terms like ‘Black Fungus’, ‘White Fungus’ and ‘Yellow Fungus’ can be misleading and create panic among people. These are all fungal infection called Mucormycosis, they explained. Dr Narreddy stressed that instead of focusing on the colour, it is important to analyse the infection, the reasons causing it and the risk factor. said,

All these fungal infections are Mucormycosis only. In cases where the fungus infects affects the nose, face, orbits of the eyes, and brain and lungs which causes the tissues to turn black and so people are calling it ‘Black Fungus’. When fungus attacks private parts, there is white colour discharge and thus the name white fungus. Now because of the yellow colour pus that is formed in the area wounded by the fungus, people are calling it ‘yellow fungus’. What is more important than defining these infections as per the colour of the discharge or how the body part looks is controlling the elements that is causing these infections. In most cases, it is the high glucose level in patients that may put them at high risk of fungal attack.

Also Read: Coronavirus Explained: What Is Mucormycosis Or Black Fungus And How It Affects COVID-19 Patients

More Cases Of Mucormycosis In The Second Wave

According to Dr Lahariya, over 10,000 cases of mucormycosis have been reported in the country. He said,

These fungal infections are not something new or unique to COVID. These infections occur in people with compromised immunity. Not just in India, fungal infections are prevalent in other countries too. People taking medications for a long time like those with diabetes, cancer, those undergoing chemotherapy, people with HIV/AIDS or those who are hospitalized, taking steroid and antibiotic can get such fungal infections.

He added that because of the current medical emergency in the country, these cases are becoming more known to the people as a large number of people are falling sick and becoming vulnerable to the infection. Dr Narreddy said,

There were fungal infection cases during the first wave as well. I reported at least 20 cases. But since the second wave is affecting a larger population, higher cases of mucormycosis are surfacing. The use of steroids has increased in the second wave which affects the immunity of the person and thus makes them more venerable to such an infection. Another potential theory that needs to be researched is the increased use of industry oxygen. We are getting oxygen from anywhere possible but do we have the surety about quality control? This theory still needs proof. Lack of cleanliness at medical facilities is also a reason.

Causes Of The Fungal Infection

Mucormycosis is caused by mucormycetes (microscopic fungi) which grows in the environment due to poor hygiene and unsanitary conditions, said Dr Narreddy. She said,

A person gets infected when the fungus enters a person through respiration or consuming contaminated food. It becomes fatal for people with weak immunity. Fungal infections are not contagious since they cannot be spread from person to person. But it is important to know that most fungal infections of this manner start off due to unsanitary conditions- poor hygiene, contaminated food, or overuse of steroids, antibacterial medications.

Patients coping with comorbidities or using immunity-suppressing medications continue to be at a greater risk for catching the infection, she said.

Watch: Dos And Don’ts Of Using Steroids In COVID-19 Treatment

Symptoms To Watch Out For

The experts said that the symptoms of the fungal infection attacking internal organs are acute lethargy and fatigue, loss of appetite, unusual weight loss, leakage of pus should be observed. Dr Lahariya asserted that signs of fungal infections at other body parts should also be observed like facial deformity, sunken eyes, slow healing of wounds and damaged tissues. He warned that it is critical that patients seek help for their infection as soon as they start observing symptoms.

How Can The Fungal Infection Be Prevented?

According to Dr Narreddy, cleanliness is the key to prevent fungal infections. She said that the surrounding should be free of moulds. She also asserted that there should minimum use of steroids and antibiotics. She said,

In the current situation, in the raging pandemic, steroids are life savers. But these must be used in minimum doses for a minimum duration. Antibiotics should be avoided as much as possible. COVID is a viral disease and not caused by bacteria. Including antibacterial medication in COVID treatment, will only harm the good bacteria in the gut.

She recommended that if a patient has comorbidities like diabetes, then the medical professional must focus on keeping the blood sugar level in check. She said,

Diabetes along with an overdose of steroids and antibiotics is the perfect recipe for fungal infections in patients.

Dr Narreddy said that fungal infections can occur in patients even after two months of receiving the overdose of steroids and antibiotics and warned that delay in treatment can be extremely dangerous.

Also Read: COVID-19 Explainer: How Are Antibodies Formed And How Long Do They Last?

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

17,91,56,496Cases
5,81,68,051Active
11,71,06,212Recovered
38,82,233Deaths
Coronavirus has spread to 193 countries. The total confirmed cases worldwide are 17,91,56,496 and 38,82,233 have died; 5,81,68,051 are active cases and 11,71,06,212 have recovered as on June 23, 2021 at 3:45 am.

India

3,00,28,709 50,848Cases
6,43,19419,327Active
2,89,94,855 68,817Recovered
3,90,660 1,358Deaths
In India, there are 3,00,28,709 confirmed cases including 3,90,660 deaths. The number of active cases is 6,43,194 and 2,89,94,855 have recovered as on June 23, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

59,87,521 8,470

1,26,468 1,055

57,42,258 9,043

1,18,795 482

Kerala

28,29,460 12,617

1,00,881 746

27,16,284 11,730

12,295 141

Karnataka

28,15,029 3,709

1,18,615 4,541

26,62,250 8,111

34,164 139

Tamil Nadu

24,36,819 6,895

56,886 4,443

23,48,353 11,144

31,580 194

Andhra Pradesh

18,57,352 4,169

53,880 4,260

17,91,056 8,376

12,416 53

Uttar Pradesh

17,04,678 202

3,910 253

16,78,486 397

22,282 58

West Bengal

14,85,438 1,852

22,508 232

14,45,493 2,037

17,437 47

Delhi

14,32,778 397

1,918 78

14,05,927 467

24,933 8

Chhattisgarh

9,91,653 482

8,007 557

9,70,244 1,032

13,402 7

Rajasthan

9,51,393 137

2,388 303

9,40,101 437

8,904 3

Odisha

8,83,490 2,957

30,859 1,240

8,48,960 4,159

3,671 38

Gujarat

8,22,620 135

5,159 480

8,07,424 612

10,037 3

Madhya Pradesh

7,89,415 65

1,707 273

7,78,902 318

8,806 20

Haryana

7,67,726 146

2,200 137

7,56,231 263

9,295 20

Bihar

7,20,207 268

2,811 206

7,07,833 468

9,563 6

Telangana

6,15,574 1,175

16,640 606

5,95,348 1,771

3,586 10

Punjab

5,93,063 405

5,968 509

5,71,207 880

15,888 34

Assam

4,88,179 2,869

32,975 350

4,50,924 2,482

4,280 37

Jharkhand

3,44,775 110

1,417 72

3,38,256 180

5,102 2

Uttarakhand

3,38,978 171

2,896 68

3,29,030 231

7,052 8

Jammu And Kashmir

3,12,584 428

7,181 578

3,01,134 999

4,269 7

Himachal Pradesh

2,00,791 188

2,276 132

1,95,062 315

3,453 5

Goa

1,64,957 303

2,920 146

1,59,029 438

3,008 11

Puducherry

1,15,364 284

3,214 150

1,10,423 433

1,727 1

Manipur

64,993 575

9,214 84

54,714 649

1,065 10

Tripura

63,140 395

3,747 163

58,735 554

658 4

Chandigarh

61,467 23

278 33

60,383 56

806

Meghalaya

45,976 421

4,273 77

40,915 341

788 3

Arunachal Pradesh

33,664 289

2,548 9

30,956 279

160 1

Nagaland

24,438 64

1,757 87

22,204 149

477 2

Ladakh

19,871 33

360 5

19,309 38

202

Sikkim

19,458 137

2,430 18

16,732 152

296 3

Mizoram

18,409 430

4,424 197

13,900 233

85

Dadra And Nagar Haveli

10,520 4

61 1

10,455 3

4

Lakshadweep

9,504 33

315 4

9,142 36

47 1

Andaman And Nicobar Islands

7,425 10

103 6

7,195 4

127

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