The Rajasthan government on Wednesday declared mucormycosis, or “black fungus”, an epidemic in the state, PTI reported.

The fungal infection, which has been found in several coronavirus patients across the country, mostly after they have recovered, involves headache, fever, pain under the eyes, nasal or sinus congestion, and partial loss of vision. The rare infection is caused by a fungus named mucor, which is found on wet surfaces.

Currently, Rajasthan has around 100 black fungus patients and a separate ward has been made at Sawai Man Singh Hospital in Jaipur for their treatment, the state’s Principal Health Secretary Akhil Arora said. Wednesday’s decision would make “black fungus” a notifiable disease in the state under the Rajasthan Epidemic Act 2020.

The disease which was initially spotted among Covid patients in Gujarat and Maharashtra, has now spread to other parts of the country as well.

MV Padma Srivastava, the head of neurology department at the All India Institute of Medical Sciences in Delhi on Wednesday said that cases of the disease has crossed the three-figure mark at the hospital, ANI reported.

More than 20 cases of black fungus are reported daily, Srivastava told the news agency, adding that mucor wards have been made separately at AIIMS Trauma Centre in Delhi and AIIMS Jhajjar in Haryana. The Sir Ganga Ram Hospital in Delhi has recorded nearly 100 cases of black fungus since May 7, according to the Hindustan Times. Currently, 69 patients are admitted in the hospital with mucormycosis.

The Madhya Pradesh government has also decided to conduct nasal endoscopy process in Covid-19 patients and survivors who are admitted in the district hospitals and the government medical colleges, PTI reported. The state’s Medical Education Minister Vishvas Kailash Sarang said the endoscopies will be conducted free of cost for early detection and treatment of the disease.

Last week, the Gujarat government had announced that all government-run hospitals reporting incidents of mucormycosis will set up separate wards to treat the infection. The Maharashtra government has also said it will cover the cost of mucormycosis treatment under its health insurance scheme.

One of the potential causes of the fungal infection is reportedly the use of steroids for Covid-19 treatment, which increases blood sugar levels.

Steroids reduce inflammation in the lungs for Covid-19 and the body’s immune system goes into overdrive to fight off the virus. However, they also may reduce immunity and push up blood sugar levels in both diabetic and non-diabetic Covid-19 patients, according to doctors quoted by the BBC. The drop in immunity might then exacerbate the “black fungus”.