Black Fungus | Business Upturn

Black Fungus: Centre releases guidelines for management in kids below 18 years

Himanjali Mahanta — Thu, 10 Jun 2021 08:30:59 +0000

The Director-General of Health Services (DGHC) under the Union Health Ministry on Wednesday issued guidelines for the management of Mucormycosis or black fungus disease in children below 18 years.

As per the Ministry of Health and Family Welfare (MoHFW), Mucormycosis is a serious fungal disease seen in patients with underlying/predisposing factors such as immune suppression, poorly controlled diabetes mellitus, misuse/overuse of steroids, cancer, organ/stem cell transplantation, and those under prolonged ICU treatment. “Do not wait for cultures to initiate therapy as mucormycosis is an emergency. Early complete surgical debridement is the cornerstone of treatment, and maybe repeated as required,” the DGHC said in its guideline.

According to the guidelines, “Conventional Amphotericin B as a prolonged IV infusion through a central venous catheter or PICC; closely monitor kidney function and electrolytes during treatment. Reconstitute in water for injection, and dilute in 5 per cent dextrose (do not use normal saline/Ringer’s lactate, start with test dose: 1 mg IV infusion over 20-30 minutes. Loading dose: 0.25-0.5 mg/kg IV infused over 2-6 hours; gradually increase by 0.25 mg increment/day to reach maintenance dose: 1-1.5 mg/kg/day.”

“Liposomal Amphotericin B or Amphotericin lipid complex, if available; prolonged infusion over 2-3 hours through a central venous catheter to PICC and closely monitoring KFT and electrolytes. Reconstitute in water for injection, and dilute in 5 per cent dextrose (do not use normal saline/ringer’s lactate); start full dose from the first day; 5mg/kg/day in case of CNs involvement),” it said.

Posaconazole should be given as salvage therapy in cases that can’t be given Amphotericin B. children less than 11 years in age dose – 7 -12 mg/kg/dose IV twice on the first day and maintenance dose – 7 -12 mg/kg IV once a day, starting on the second day,” it added.

Black Fungus: Medicine shortage in Bihar as state records over 400 cases

Aryan Jakhar — Sat, 05 Jun 2021 08:41:10 +0000

Cases of the deadly Black Fungus are on the rise in Bihar with the state government confirming there have been more than 400 infections. So far, 39 people have died due to the disease. Most of the patients are being treated at two hospitals – All India Institute of Medical Sciences (AIIMS), Patna and Indira Gandhi Institute of Medical Sciences (IGIMS) – as two other Covid hospitals lack tools for surgery to treat mucormycosis, commonly known as Black Fungus.

With most patients going to AIIMS and IGIMS for treatment – where there are just 260 beds for such cases – the hospitals are facing a crunch.

Lack of beds and medical supplies have sent the two hospitals into a tailspin as they struggle to accommodate the overpouring patients. Doctors say that a major hindrance in treating the patients is the shortage of the key drug Liposomal Amphotericin B used to treat Black Fungus.

“All the Black Fungus cases at the hospital are very severe and around 50 per cent of patients’ brain has been affected,” Dr Kranti Bhavna Additional Professor AIIMS Patna told NDTV. The doctor says she feels helpless as no matter how much effort they put in, everything is in vain if there is no medicine.

“Lack of medicines is the biggest problem. As a doctor, I feel bad that at the end of the day it is a medical problem and even if I operate, I don’t have the drug, what will happen?” Dr Bhavna added.

Dr Manish Mandal, the Superintendent of IGIMS, says the fatal disease has seeped into villages due to lack of cleanliness. “We have hospital beds; we are getting medicines slowly. We have received 500 vials with which we can treat 100 patients; each patient requires 5 vials of the drug,” Dr Mandal adds.

The state government is in denial mode about the situation and claims that the shortage of medicines is being dealt with on priority and all patients are being administered the drug-free of cost on admission to hospitals.

“The spike in Black Fungus was reported on around May 12 or 13. The state immediately issued an order and medicines were dispersed to hospitals as early as May 15 to tackle the crisis,” Health Minister Mangal Pandey told NDTV.

50 people died in Haryana due to Black Fungus, says CM Khattar

Aryan Jakhar — Sun, 30 May 2021 08:17:51 +0000

Haryana Chief Minister Manohar Lal Khattar on Sunday said 50 people have died due to black fungus in the state so far, while 650 more are undergoing treatment for the infection in various hospitals.

“There have been over 750 cases of black fungus in Haryana so far. Fifty-eight have been cured while 50 people have lost their lives and 650 patients are seeking treatment,” Khattar said during a news conference here.

Addressing the conference virtually, he said the government was procuring the injection used in the treatment of black fungus while some stock was already available and was being used in government hospitals.

“We have got 6,000 injection vials. Over the next two days, we will get 2,000 vials more while we have placed an order for another 5,000 vials, he said.

Nasal Aspergillosis: After ‘Black Fungus’ another fungal infection is on rise

Aryan Jakhar — Fri, 28 May 2021 10:46:22 +0000

Nasal aspergillosis, which infects the sinuses, joins the growing list of deadly fungal infections that have tagged along with the Covid-19 virus, with at least eight patients in Vadodara being admitted on account of the disease.

Two of Vadodara’s government hospitals, which are collectively treating 262 patients for mucormycosis or ‘black fungus’, have now reported cases of invasive nasal aspergillosis over the past week in Covid-19-positive and Covid-19-recovered patients, according to multiple media reports.

In the aftermath of the second Covid-19 wave in the country, a suite of fungal infections—black, white and yellow fungus—have been reported with increasing frequency, trend health experts hypothesise could be a result of weakened immune systems due to excessive use of steroids to treat Covid-19 patients with acute diabetes and unsanitary use of oxygen cylinders.

The rapid spread of black fungus caused by a type of mould has prompted several states to declare it an epidemic to keep a tab on its spread and enforce measures to contain it.

Aspergillosis is also caused by a species of mould found all over the world called aspergillus in everything from the air to damp soil and decaying organic matter. While mostly harmless, some varieties could cause a range of diseases in humans ranging from simple allergic reactions to a life-threatening invasive disease.

The symptoms of the infection include a stuffy or runny nose, congestion, fever, facial pain and headache. A distinctive fungal ball of fungus fibres, mucus, cells and blood-clotting protein may also form in the sinuses and the infection could spread to other areas including the brain. Nasal aspergillosis is sometimes also linked with bone loss of the facial bones.

Invasive nasal aspergillosis is far more common in severely immunocompromised patients, though non-invasive types can occur even in normal hosts, studies on the disease have shown. Nasal aspergillosis has also been found to have a case fatality rate or deaths-to-cases ratio of 66%, according to a 2001 paper titled Aspergillosis case-fatality rate: Systematic Review of the Literature.

All the fungal infections cropping up in the country at present are treated with a single antifungal drug called Amphotericin B, but the study had found that mortality due to the aspergillosis family of infections was high “Despite improvements in diagnosis and despite the advent of newer formulations of amphotericin B.”

Black Fungus cases touches record 11,717 mark in India; Gujarat tops the list

Aryan Jakhar — Wed, 26 May 2021 11:07:10 +0000

India has recorded 11,717 cases of Mucormycosis or Black Fungus, so far, with Gujarat, Maharashtra and Andhra Pradesh logging the highest number of cases, as per the latest government data.

The government has allocated 29,250 additional vials of Amphotericin-B drug to states and Union Territories, Union Minister for Chemicals and Fertilisers Sadananda Gowda said on Wednesday.

Amphotericin-B is used to treat Mucormycosis, also known as Black Fungus, which damages the nose, eyes, sinuses, and sometimes even the brain.

“Additional 29,250 vials of #Amphotericin- B drug, used in the treatment of #Mucormycosis, have been allocated to all the States/UTs today. The allocation has been made based on the number of patients under treatment which is 11,717 across the country,” Gowda tweeted.

Additional 29,250 vials of #Amphotericin– B drug, used in treatment of #Mucormycosis, have been allocated to all the States/UTs today.

The allocation has been made based on the number of patients under treatment which is 11,717 across the country.#blackfungus #AmphotericinB pic.twitter.com/j0LyR6GLjH

— Sadananda Gowda (@DVSadanandGowda) May 26, 2021

The government has allocated 7,210 vials to Gujarat, followed by 6,980 vials to Maharashtra as part of the 29,250 fresh allocations.

Gujarat and Maharashtra currently lead in Mucormycosis infections in the country with 2,859 and 2,770 cases respectively.

Other states like Andhra Pradesh (1,930), Madhya Pradesh (1,910), Telangana (1,890), Uttar Pradesh (1,780), Rajasthan (1,250), Karnataka (1,220), Haryana (1,110) also received additional vials to counter the disease.

The government had allocated 19,420 vials of Amphotericin-B to various states, Union Territories (UTs) and Central Institutions on May 24. Earlier on May 21, the government had allocated 23,680 vials of the drug to various states and Union Territories.

Mucormycosis is a very rare infection that is caused by exposure to mucor mould which is commonly found in soil, plants, manure, and decaying fruits and vegetables. It affects the sinuses, the brain and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals such as cancer patients or people with HIV/AIDS.

The doctors in India are documenting an alarming number of cases of Mucormycosis among patients with COVID-19 and those who have recently recovered. They believe that Mucormycosis may be triggered by the use of steroids, a life-saving treatment for severe and critically ill COVID-19 patients.

Diabetic patients should always monitor and control their blood sugar level, the Health Ministry has said. “Misuse of steroids” should be avoided, it has underlined.

Gujarat witnesses its first case of Mucormycosis in a 15-year old child

Meemansa Shekhawat — Sat, 22 May 2021 17:05:48 +0000

After hitting the states like Rajasthan and Telangana, mucormycosis, known as the black fungus has knocked Gujarat, too.

The state, on Saturday, reports the very first case of black fungus in a 15-year old child.

“This is the first case of pediatric mucormycosis in Ahmedabad”, said pediatric doctor Abhishek Bansal, on Saturday, according to ANI.

Well, the boy was discharged from the hospital after having successfully fought out Covid-19. Later he was diagnosed with mucormycosis. He’s stable now and will be discharged after two or three days, ANI reported quoting doctor Bansal.

Furthermore, Rajsthan and Telangana have already declared mucormycosis an epidemic. Further, the center has also urged the states to take proper precautions against black fungus.

Amid the Covid-19 catastrophe, cases of black fungus have sprung up in those patients who were in the recovery phase of Covid-19 contagion. It’s also being observed that mucormycosis tends to hit the ones who have a weaker immune or who have comorbidity like diabetes. Its symptoms may include blood coughing, respiratory issues, blackening or discoloration over the nose, and, blurred or double vision accompanied by chest pain.