Apart from the Coronavirus disease (Covid-19) pandemic, India is also struggling with one of its serious complications that are called mucormycosis or black fungus. Normally a rare disease, mucormycosis has been reported in thousands of Covid-19 positive individuals across the country. With many of them succumbing to it, it has been declared an epidemic by states like Rajasthan. Black fungus cases have shown a mortality rate as high as 50%; Maharashtra alone has reported at least 50 deaths, and other states, such as Madhya Pradesh, have also reported deaths.

The condition may be reaching epidemic proportions currently because of Covid-19, but mucormycosis was not unheard of in India even in the pre-Covid era. Due to lack of population-level data, its exact burden may not be known, but basing our knowledge on certain papers, and after speaking to critical care experts, we can call it a rare condition.“I cannot talk about disease incidence as such, but in our clinical life, we would see maximum five to seven such patients in the intensive care units. It was rare,” said DrAnjanTrikha, professor, department of anesthesia, critical care and pain medicine, All India Institute of Medical Sciences (AIIMS), Delhi. Chakrabarti et al. showed an increasing trend of mucormycosis from a single center at successive periods, with an annual incidence of 12.9 cases per year during 1990–1999, 35.6 cases per year during 2000–2004, and 50 cases per year during 2006–2007. The overall numbers increased from 25 cases per year (1990–2007) to 89 cases per year (2013–2015),” say authors in the paper.

“…A multicentre study across India reported 465 cases from 12 centers over 21 months; the study reported an annual incidence of 22 cases per year and an average of 38.8 cases for each participating center… Without population-based estimates, it is difficult to determine the exact incidence and prevalence of mucormycosis in the Indian population. The computational-model-based method estimated a prevalence of 14 cases per 100,000 individuals in India,” it added.