As coronavirus-hit India now braces itself for the new black fungus or mucormycosis nightmare, Rajasthan on Wednesday became the first State to declare the rare but potentially fatal fungal infection as an epidemic even as Haryana and Gujarat a few days ago categorised it under the notifiable disease to ensure its better management amid the deadly second wave of Covid.
An epidemic denotes a widespread occurrence of an infectious disease in a community at a particular time while a notifiable disease is any disease that is required by law to be reported to Government authorities.
As of Wednesday, Rajasthan had nearly 100 cases of black fungus, while Haryana and Gujarat had 115 cases and 900 cases respectively.
In fact, many other States too across the country like Maharashtra (1,500-2,000 cases) Karnataka (97), Uttarakhand (38), Uttar Pradesh (50), Telangana (50), Delhi (130) Odisha (10), Madhya Pradesh (281) and Bihar (30) are reporting a spike in the black fungus cases among recovering and recovered Covid-19 patients.
Most of the States have already started reporting mortalities in the fungus-infected patients. The fungus mostly attacks the virus-recovered immune-compromised or diabetic patients. Unsupervised and unregulated drug usage besides lack of surveillance of blood sugar levels are being attributed to the rare disease’ mortality rate at 50 per cent.
Health experts are expecting to see more mucormycosis cases in the next few weeks amid a devastating second wave of the coronavirus in India, known as the diabetes capital of the world.
For instance, health experts have warned that Bihar may see between 1,000 and 1,500 patients with black fungus by the end of May this year on the basis of the rate of infection of Covid witnessed in rural areas. The situation is likely to be no different in other medical facilities-starved villages in the country which are witnessing a surge in Covid-19 cases.
As the cases spike, the treatment drugs like Amphotericin B are drying up from the market across the States, including the national Capital and NCR, resulting in rampant black marketeering of the drug.
An anti-fungal intravenous injection which costs 3,500 rupees ($48) a dose and has to be administered every day for up to eight weeks is the only drug effective against the disease. Social media feeds and WhatsApp groups are already flooded with SOS messages from across the country from the desperate needy.
States are gearing up to deal with the new threat. Telangana has dedicated its two hospitals to exclusively treat the cases of black fungus. “A separate 250-bed mucormycosis ward has been established in Rajkot,” said Dr RS Trivedi, medical superintendent of Surat Medical College in Gujarat. Also, many States have started floating tenders for Amphotericin B, Posaconazole, and Isavuconazole with some of them regulating their allocation besides setting up expert panels to tackle the disease.
Earlier this week, the shortage was also flagged by hospitals in Gurugram, leading to the Haryana Government forming a panel to procure the injections hospitals have been using to treat recovering Covid patients who have developed mucormycosis (black fungus).
The disease is causing blindness in some cases. If left uncared for, mucormycosis may also turn fatal, stated an advisory released by the ICMR and Union Health Ministry even as the All India Institute of Medical Sciences (AIIMS) is developing guidelines to treat black fungus or mucormycosis which is aggravated by excessive usage of steroids given by doctors for Covid-19 treatment.
The disease is caused by a set of micro-organisms known as mucormycetes, which are present naturally in the environment, seen mostly in soil and in decaying organic matter like leaves, compost and piles. People catch mucormycosis by coming in contact with the fungal spores in the environment.
It can also develop on the skin after the fungus enters the skin through a cut, scrape, burn, or another type of skin trauma.
Doctors said most of their patients arrive late, when they are already losing vision, and doctors have to surgically remove the eye to stop the infection from reaching the brain.
