Black fungus infection much higher in second wave | Economic Times

As Mucormycosis or black fungus cases rise across states, medical specialists have warned of a ‘pandemic within Covid-19 pandemic’.The number of black fungus infection reported from hospitals have increased at least 100 times over the cases reported in the first wave. Mucormycosis is reported as a post Covid-19 complication among some, about 12-15 days after recovery. Rajasthan, Haryana, Delhi, Chhattisgarh, Maharashtra, West Bengal are some of the states which reported high numbers. Rajasthan on Wednesday declared Mucormycosis as an epidemic under the Rajasthan Epidemic Act 2020. Rajasthan and Haryana have made Mucormycosis a notifiable disease which makes it mandatory for hospitals to report every case to authorities. “The numbers are alarming. Mucormycosis is rare and probably we saw one case in a month in the first wave but now we are getting 10-12 cases per day. It is a short pandemic within Covid-19 pandemic,” said Medanta Medicity’s ENT and head neck surgery chairman KK Handa. Patients report to hospitals with blurred vision, discoloration or blackening of tissue on nose and cheeks and black lesions inside the mouth or discharge from nose.“Every day, we get 10-12 patients. Almost all patients have diabetes or pre-diabetes, which has flared up because of the use of high doses of steroids,” said Fortis Memorial Research Institute’s Otorhinolaryngology director Atul Mittal.State governments have started collating data from hospitals and conveying to Indian Council of Medical Research. So far, the health ministry has not released any data for the disease. Last week NIti Aayog member VK Paul had said there was no “big outbreak” of black fungus. “The awareness is low and people are reporting late to hospitals. If untreated, mortality is as high as 80% and if treated it is 40-50%. If it is caught early at the sinus stage, the patient recovers well. If you delay further, the patient develops eye problem and even later means brain involvement as it spreads,” said Handa. The treatment is long and involves surgeries to remove (mostly endoscopically) dead tissue. “It takes 4-6 weeks of treatment and ICU setup with a team of doctors across specialties,” said Indian Spinal Injuries Centre’s anesthesiologist HK Mahajan.The current situation has become alarming due to shortage of anti-fungal drug, Liposomal Amphotericin B. The Centre has asked states to form a committee of doctors to go through all requests from hospitals and then sanction stocks of the medicine to each of them. The committee sits twice a day but this has not eased the situation. All doctors confirmed to ET that their hospitals had not got the drug for two days. “The major reason is that there is less production as it is a rare fungal infection and may be nobody could foresee that this would emerge in such high numbers. Over the last two days we have had no availability. So we have moved to second line drugs like Posaconazole,” said Handa. Aakash Healthcare MD Aashish Chaudhry said: “The access to liposomal Amphotericin B is not easy. The government has controlled the supply and there is very little availability. If a patient does not have any renal issue, we try and treat them with normal Amphotericin.”