‘Green Fungus’ Case Reported in India: What Is It? Who Is at Risk?

A 34-year-old COVID survivor was diagnosed with a rare infection called ‘Green Fungus.’ Here’s what we know.

A 34-year-old patient in Madhya Pradesh was diagnosed with a rare infection called ‘Green Fungus’ or Aspergillosis, after recovering from a two-month long battle against COVID-19.

He was transferred to Mumbai’s Hinduja Hospital by air ambulance for treatment, reports said on Tuesday, 15 June.

This is the first reported case of the infection in the country.

What is Aspergillosis? Who is at risk? Here’s what we know about the rare infection:

What is Aspergillosis?

Aspergillosis is a fungal infection that most commonly affects the lungs, Dr Randeep Guleria, AIIMS Director, informed in his press conference, as early as 24 May.

Aspergillosis is an infection caused by a common mold – Aspergillus – which lives indoors as well as outdoors.

How can people get infected?

People can get infected with green fungus by breathing in microscopic Aspergillus spores from the environment.

According to the US Centres for Disease Control and Prevention (CDC), “most people breathe in Aspergillus spores every day without getting sick". However, weakened immune systems or lung diseases puts one at a higher risk of catching the infection.

Who is at risk?

People with weakened immune systems, such as COVID survivors, or those who have lung diseases, are at a greater risk of developing health issues due to the infection, says CDC.

Those who have have:

• Cystic fibrosis or asthma
• Tuberculosis, chronic obstructive pulmonary disease (COPD), or sarcoidosis.

“We mostly see people with low immunity get affected by Mucormycosis, Candida, and Aspergillosis.”

Dr Randeep Guleria, Director, AIIMS explained

What are the symptoms of Aspergillosis?

According to the CDC, different types of the infection have different symptoms.

Allergic bronchopulmonary aspergillosis (ABPA):

• Wheezing
• Shortness of breath
• Cough
• Fever (in rare cases)

Allergic Aspergillus sinusitis:

• Stuffiness
• Runny nose
• Headache
• Reduced ability to smell

Aspergilloma (“fungus ball”):

• Cough
• Coughing up blood
• Shortness of breath

Chronic pulmonary aspergillosis:

• Weight loss
• Cough
• Coughing up blood
• Fatigue
• Shortness of breath

Invasive aspergillosis:

• Fever
• Chest pain
• Cough
• Coughing up blood
• Shortness of breath
• Other symptoms can develop if the infection spreads from the lungs to other parts of the body.

Is it contagious?

No. Aspergillosis cannot spread between people or between people and animals.

What is the connection between Aspergillosis and COVID?

Infections like green, black, white, and yellow fungus are not new, and neither are they unique to the COVID-19 virus, FIT reports. But being associated with COVID has put them in the spotlight like never before.

“Any critically ill person is prone to what is is called ‘invasive candidiasis’... A severe infection can lead to a secondary infection. If you have a severe septicemia because of bacterial infection or viral infections, you can get a secondary fungal infection because of the immunity being compromised.”

Dr Sumit Ray, critical care medicine, Holy Family Hospital, Delhi, while speaking to FIT

Are ‘Green Fungus’ and ‘Black Fungus’ the correct ways to refer to these infections?

Although we commonly use terms like ‘black’ and ‘green’ fungus, Dr Guleria has warned of the confusion these colour labels might create.

“It is better to use the correct names. If the fungus grows in certain areas, the colour may look different, and calling the same fungus by different colour labels will create confusion.”

Dr Randeep Guleria, Director, AIIMS