Can spurt in black fungus cases be blamed on industrial oxygen cylinders, dirty water in humidifiers?

Doctors deal with a affected person contaminated with black fungus in Madhya Pradesh (Source: PTI)

At a time when a number of secondary fungal infections are being reported amongst these recovering or recovered from Covid-19, especially black fungus, there is a debate on whether or not unhygienic supply of oxygen to sufferers may be a possible trigger behind such cases.

While uncontrolled diabetes and use of high dose steroids, which suppress immunity, have been recognized as the first components behind the cases of black fungus or mucormycosis, specialists advised IndiaToday.in that contaminated water used in humidifiers, unsterilised gear and non-medical grade oxygen cylinders may additionally play a potential position.

“In the second wave, industrial oxygen has been diverted for medical use. We have seen these industrial oxygen cylinders, which are not medical grade and prone to leaks, being transported in trucks and vans. Thus, hygiene of cylinders could have been compromised. Secondly, the water used in humidifier bottles through which oxygen is given needs to be sterile and clean. If not, the risk of contamination increases by breathing in fungal spores,” infectious ailments specialist Dr Ishwar Gilada advised IndiaToday.in.

In the same vein, Dr Kapil Salgia, pulmonologist on the Bombay Hospital, who has been treating black fungus sufferers, stated cannulas and oxygen masks for each Covid-19 affected person ought to be discarded and new ones ought to be used for the following affected person.

“Due to shortage of oxygen, we have seen two patients using the same cylinder and even the same non-rebreather mask. This could have also led to fungal infections,” Dr Kapil Salgia stated.

Earlier this week, Karnataka deputy chief minister CN Ashwath Narayan said {that a} team of microbiologists would study whether or not the rise in black fungus cases in the state was linked to the usage of industrial oxygen and its potential contamination.

READ | Probe link between Black Fungus, use of zinc in treatment of Covid patients: Experts

‘No direct hyperlink between industrial oxygen and black fungus cases’

However, opinion is split on this level.

Dr Kapil Salgia additionally highlighted that unhygienic practices in hospitals usually are not a brand new phenomenon and equally, steroids have been administered to Covid-19 sufferers in the primary wave as properly, however not many black fungus cases have been witnessed.

Padmashree awardee Dr JM Hans advised IndiaToday.in there was no direct hyperlink between industrial oxygen and sanitation of cylinders to the sudden surge in mucormycosis cases.

Doctors performing a Diagnostic Nasal Endoscopy to detect black fungus in a affected person at a hospital in Jabalpur (Photo Credits: PTI)

“When it comes to oxygen — whether industrial or not — it passes through water which traps the fungal spores. The oxygen which is passed then is without fungal spores. The sanitation of ICU pipes and other equipment could cause any virus, why just mucor? [sic]” Dr JM Hans stated.

ALSO READ | How to identify black fungus cases, what to do next? AIIMS issues new guidelines

“The humidity in the nose due to the use of oxygen passing through water, poor and constant use of masks and people doing steam inhalation 10 to 12 times a day may be the causes for colonisation of the fungus in the nose. When the body is in an immunocompromised state, this non-invasive fungus becomes invasive,” Dr JM Hans defined.

Dr Anup Sabarwal, ENT specialist, Rosewalk Hospitals, stated theories linking oxygen cylinders and industrial oxygen to black fungus cases have been a bit far-fetched. “Use of industrial oxygen per se cannot be a reason because that is 100 per cent pure oxygen and would kill off everything — it could only be more sterilising,” Dr Sabarwal stated.

An audit of cases in Rajasthan by Dainik Bhaskar discovered that 57 per cent of black fungus sufferers weren’t on oxygen assist and 27 per cent of them didn’t even take steroids. Rajasthan has reported over 100 black fungus cases.

Climatic circumstances behind spurt in black fungus cases?

Experts additionally stated it ought to be studied whether or not sure weather conditions have been linked to rise in mucormycosis and different fungal infections.

“The fungus is found more in areas where there is humidity like Mumbai than interior places of Maharashtra. Mumbai is seeing a lot of black fungus cases,” Dr Ishwar Gilada stated.

Echoing him, Dr Kapil Salgia stated heat and moist areas have been breeding grounds for fungus. “It needs to be studied if the black fungus cases are from Mumbai itself or are they being transferred from a smaller setup. Since Mumbai has tertiary care facilities, patients from mofussil are coming here for better healthcare,” he stated.

Maharashtra has reported the very best variety of black fungus cases at over 2,000 and greater than 90 deaths, based on the state well being division.

A health care provider checking a affected person for black fungus at a hospital (Source: PTI)

Precautions

For Covid-19 sufferers recovering at house, Dr Gilada, who can be the final secretary of the Organised Medicine Academic Guild (OMAG), stated sure precautions ought to be taken to stop fungal infections.

“Mucor fungus is everywhere…it is in the air, near AC ducts, in the soil, decaying organic matter. Rooms where Covid-19 patients are kept should be clean, have proper cross-ventilation, fans should be at full speed and minimise use of AC. Ensure sterile water is used for humidification in oxygen tube. Tubes should be cleaned with betadine two-three times a day,” Dr Gilada stated.

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