The deadly black fungus or mucormycosis continues to sweep India. From around 8,000 plus cases reported on May 22, the cases spiked to 11,717 on Tuesday. In other words, the country has added 1,000 cases of black fungus everyday in the last few days.
As the cases are on upswing so is the demand for Amphotericin B, the main drug to treat the fungal disease. Union Minister for Chemicals and Fertilisers DV Sadananda Gowda on Wednesday said an additional stock has been allocated to all the States and Union Territories.
The shortage of drug has made the people to take recourse to the social media which is flooded with such SOS messages.
As per the data made available by the Government, as on May 25, Gujarat has the highest number of black fungus cases at 2,859, closely followed by Maharashtra ( 2,770 cases). Andhra Pradesh has reported 768 cases, while Telangana and Uttar Pradesh have 744 and 701 cases respectively.
As per the data tweeted by the Union Minister of Chemical and Fertilser, no case has been reported from the Northeast region as well as West Bengal. The cases may be on the higher side given that as per various media reports, West Bengal which has notified the disease has recorded two deaths so far and 10 people were under treatment for the disease till Monday.
The Centre has allocated a total 29,250 additional vials of Amphotericin-B, a key drug to treat mucormycosis cases to the States and Union Territories for the patients currently being treated at different hospitals across the country. Gowda on Wednesday said the allocation has been made based on the number of patients under treatment which is 11,717 across the country. “Earlier, 19,420 vials of Amphotericin- B were allocated on May 24 and 23,680 vials of the drug were supplied across the country on 21st May.” (See Box)
However, the States are not satisfied at the allocation of the drug as they grapple with the surge in cases among Covid patients and those recovered from it.
For instance, as per the data shared by the Ministry, Delhi has 119 cases, whereas the State Chief Minister Arvind Kejriwal has put the number at 620. Similarly, Amisha Rajani from Indore Covid Help organization too rued that Indore is grappling with a shortage of key Amphotericin-B injection used in its treatment. “According to the allocation details, there should be at least 2 injections available for every patient in Madhya Pradesh. But we’ve got 50 injections on for 221 active black fungus cases in Indore. What about the rest of them? 171 patients with no injections?” she asked.
“Usually, four to six doses of Amphotericin-B are to be administered on the first day of treatment to black fungus patients. After that, three to four doses are needed every day for the next 10-days,” said Dr Ravi Dosi, head, Chest Diseases Department in Sri Aurobindo Institute of Medical Sciences (SAIMS) in the district.
Dr Rahul Bhargava, Director, Department of Clinical Hematology and Bone Marrow Transplant, Fortis Hospital in Gurugram pointed out that no doubt main stay of treatment of mucormycosis is surgery and amphotericin. But in case of shortfall or not being able to be given because of kidney issues another drugs like Posconazole and Isavuconaozle, both of which are available, can be given for the treatment of the fungal disease. Treatment needs to be taken for 2 to 3 months, he suggested.
Those having health conditions such as uncontrolled diabetes, suppression of immune system by steroids, prolonged stay in ICU, comorbidities post-transplant and malignancy are prone to be attacked by the fungal disease. At least, 11 States have notified the disease so far while others are in the process.
The cases are expected to rise given that the prevalence of diabetes in the country is as high as 12% to 18% of the adult population, especially in urban areas and they are most vulnerable to the Covid disease.
According to a study, the black fungus mortality rate in India is “considerably high due to delays in seeking medical attention and diagnosing the disease, and challenges in managing the advanced stage of infection.”
Caused by mold found in damp environments like soil or compost, black fungus can attack the respiratory tract. It is not contagious and commonly affects the sinuses or lungs after a person inhales fungal spores in the air, and can also affect the skin following a surface injury like a cut or burn. Symptoms depend on where in the body the fungus is growing, but can include facial swelling, fever, skin ulcers and black lesions in the mouth.
