Maharashtra / Black Fungus killed 90 people, affected 1,500 in Maharashtra: Rajesh Tope

Mumbai: Maharashtra has recorded 90 deaths of recovered Covid-19 patients owing to mucormycosis, also called black fungus. So far, Maharashtra has reported around 1,500 infections and has around 850 active patients across the state, state health minister Rajesh Tope said on Wednesday. He also asked the Centre to immediately release allocation of Amphotericin B injections, which is used to treat the disease, as the state is getting around 300-400 cases every week.

The issue was also discussed in the state cabinet meeting as ministers raised concern over rising cases of mucormycosis. The state has a stock of only 16,000 doses which were distributed among the districts based on the number of active cases, officials said.

Mucormycosis is a rare fungal infection that is found in immunodeficient patients.

The state government has placed an order of 190,000 doses of Amphotericin B, but the companies are unable to supply the stock as the Centre has decided to regulate its supply and will determine its allocation based on the availability in the market, Tope said.

“Around 1,500 patients are found infected with mucormycosis in the state till date. Of them, the state has around 850 active patients who are getting treatment in various districts, the rest have been discharged from hospitals after recovery. There are also 90 casualties recorded owing to the disease thus far,” Tope told reporters on Wednesday after the cabinet meeting.

“We want the Centre to make allocations of Amphotericin B immediately as its cases in the state are rising continuously. Last week, the state clocked around 400 cases. We have also floated a global tender to get doses from the international market. There is no reason for the state to take it lightly and we are exploring all the possible options available with us,” he added.

Covid patients who were treated with excessive use of steroids and those with high diabetes are usually found infected with the disease. This is the reason the state government has recently issued detailed guidelines on its symptom, medical investigation, prevention and treatment protocol for local authorities and doctors on May 17. HT was the first to report this on May 18.

The guidelines were issued with an aim to reduce morbidity and mortality among mucormycosis patients. It asked for strict glycemic control during management of Covid-19 patients which means blood sugar levels must be continuously controlled. It added that systemic steroids can be used only in patients with hypoxemia, and if used blood sugar level should be monitored.

The state government has also declared to treat patients suffering from mucormycosis under Mahatma Jyotirao Phule Jan Aarogya Yojana (MJPJAY) for free. It has also decided to remove the cap of ₹150,000 for treating a patient under the scheme only for this disease, Tope said.

“Strict infection control measures including cleaning and replacement of humidifiers (to be implemented). Sterile normal saline should be used in the humidifier bottle and changed daily and masks should be disinfected daily. Local public health laboratory should be asked to take swabs of humidifiers, masks, tubing and common touch areas for culture of mucormycosis,” stated the order issued by Ramaswami N, commissioner, health services and mission director, National Health Mission (NHM), Maharashtra on May 17.

It has asked the doctors not to miss warning signs and symptoms and also to not consider all cases of blocked nose as cases of bacterial sinusitis, especially in the context of immunosuppression and Covid-19 patients on immunomodulators.

It also described signs and symptoms of mucormycosis comprising pain and redness around eyes and nose, fever — usually mid, epistaxis (bleeding from the nose), headache, cough, shortness of breath, blood vomiting and altered mental status.