Excess zinc and antibiotics behind black fungus outbreak
While India is still reeling under the mounting cases of COVID-19, a deadly fungal infection called mucormycosis or black fungus has triggered a new health challenge in the country. More than 11,000 cases of black fungal infection have been reported from different parts, forcing state governments to declare it an epidemic. This rare fungal infection that has emerged during the second wave of coronavirus has been widely linked with excessive usage of steroids and uncontrolled diabetes in coronavirus positive patients. Now experts are pressing to examine the blanket use of zinc in treating Covid-19 infections, fearing that it may be linked with the outbreak of mucormycosis.
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What experts say
Taking to his Twitter handle, former president of the Indian Medical Association (IMA), Dr Rajeev Jayadevan emphasised to look into the role of excessive usage of steam, intake of zinc supplement and combination antibiotics used to treat coronavirus in the black fungal outbreak. He cited a study carried out on 210 SARS-CoV-2 positive patients across 4 hospitals by Dr VP Pandey, HOD Mahatma Gandhi Memorial Government Medical College, Indore and pointed out how these three factors can contribute to the growth of fungus.
In his tweet, he mentioned that the cocktail of antibiotics - Azithromycin, Doxycycline and Carbapenem- can increase the risk of fungal infection.
"Fungi thrive in a zinc-rich environment, and mammalian cells try to keep zinc away from fungus to avoid infection," he tweeted.
"Steam in excess can damage the delicate mucus layer and even cause burns along the mucosa, making it easy for fungus to breach our natural defence. Burns caused 10-20% of past mucormycosis in India," Jayadevan added.
Jayadevan stated that about 21 per cent of the patients analysed in the study were not diabetic and just about 52 per cent of the patients were on oxygen.
COVID-19 medications and black fungus
In about 80 per cent of COVID cases in the country, patients are being prescribed paracetamol to control the temperature, and other five to seven medicines consisting of supplements and antibiotics. Along with that, people are advised to take steam 2-3 times a day.
There is no particular medication available to treat COVID-19. Patients are prescribed a combination of antibiotics to cure the growth of the virus.
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Use of zinc and stream in treating COVID
Zinc supplements are recommended to boost immunity and for speedy recovery. Zinc helps to activate more than 300 enzymes in the body that support different functions, including strengthening the immune system. Previous reports suggest that zinc can act as a growth factor for fungus, especially mucormycosis. Studies also suggest that removing zinc can make it difficult for the fungus to survive.
Steaming has emerged as a popular technique to fight COVID as it is considered useful to relieve congestion or cold in the upper respiratory tract. But experts believe that it does not help with pneumonia or any condition of the lung.
Industrial oxygen also linked with black fungus cases
According to another theory, the use of industrial oxygen cylinders can also be connected with the rising fungal cases in the country. With the rise in the demand for oxygen supply in the country, a large amount of industrial oxygen had been diverted for medical purposes. In several places, industrial cylinders are also used in place of medical oxygen cylinders. Though oxygen used in the industries is purer than medical oxygen, industrial cylinders are not as good as medical oxygen cylinders. There are several micro leaks and are not maintained hygienically. Industrial oxygen cylinders with contaminated water and soil from inside could also lead to the growth of fungus. Still, a lot more research is needed in this area before coming to any conclusion.