Startled by the sudden spurt in the numbers of cases of black fungus (Mucormycosis) in the last few days, the Madhya Pradesh government has chalked out a plan to counter the disease reported by Covid-19 patients who have recovered from the virus.
The state government on Wednesday announced to set up black fungus treatment units at the government medical colleges in Bhopal and Jabalpur with ten beds facility each.
At least two persons have died in Indore and their casualties have been linked by physicians to black fungus infection. While the police constable Ramkumar Shukla who died of post-Covid-19 complications in Gwalior on Wednesday is also suspected to have a black fungus infection, the physicians are yet to confirm the same. The victim's kin, however, claimed that the old man had severe swelling in his eyes.
In Bhopal, physicians had to extract nine teeth and the jaw of a patient while another one lost an eye due to the severe black fungus infection. Jabalpur also has reported these cases including two deaths. These include Devanshu Verma (28) who died after recovering from Covid-19 on May 3. Rupesh Kumar too died after reporting the loss of vision due to infection last Monday.
Itarsi's Dr Pratap Verma, who had recently recovered from Covid-19, had developed a black fungus infection in one of the eyes and despite hectic treatment at Hoshangabad, he has lost vision and his situation is still critical.
Black fungus, or mucormycosis, is a fungal infection reported among patients who have recovered from the coronavirus. Maharashtra, Delhi, Uttar Pradesh and Odisha have logged such cases over the past week amid spiralling cases of coronavirus.
Alarmed by the spurt in fresh cases of mucormycosis in Madhya Pradesh, the health machinery has swung into action.
Meanwhile, Madhya Pradesh Chief Minister said that the State has reported 50 cases of black fungus infection as of now. "Black fungus cases were concerning," he said, adding treatment should be ensured following the protocol. He pointed out that black fungus treatment remains costly so efforts will be made to ensure free treatment to the economically weaker sections.
Contrary to official figures, sources claimed that the number of black fungus cases could be more than what the administration has counted.
The State government on Wednesday announced to set up black fungus treatment units at the government medical colleges in Bhopal and Jabalpur with ten beds facility each. ENT, ophthalmology, numerology and medicine departments will be combined to set up these units, Medical Education Minister Vishwas Sarang said.
Mostly the patients require surgery for the removal of infected organs, so separate operation theatres will be established for black fungus patients. As the treatment requires costly injections which are generally not available in local drug markets, the State government has placed orders for these injections. Efforts will be initiated to ensure that no black marketing takes place and these injections are easily available, the minister said.
Preliminary medical assessments have claimed that Covid-19 patients offered heavy doses of steroids normally suffer black fungal infection after the recovery. So the minister, during a meeting of experts at the Gandhi Medical College, Bhopal, had issued instructions that steroids should be offered as per the standard protocol.
The health department has urged the patients to not hide these symptoms and go for a medical examination in case they spot any suspicious symptom.
The government also decided to launch a campaign for raising awareness among the patients and physicians on this infection.
To add, Amphotecirin B50 injections used to cure black fungal infection is not available in drug stores in Bhopal, Jabalpur and Indore. As patients allege that the druggists are hoarding the injections, chemists claim that it's a rare disease so mostly they keep one or two vials in stock but the patients have surged suddenly.
The symptoms of the black fungus include pain and redness around the eyes and/or nose, fever, headache, coughing, shortness of breath, blood with vomiting, altered mental status. Uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICU stay, co-morbidities, post-transplant/malignancy, voriconazole therapy are some of the reasons that increase the risk of black fungus infection.
US physician extends help
During the high-level meet at GMC Bhopal on Wednesday, US-based infective diseases expert Dr Manoj Jain was invited through a video conference. Dr Jain discussed the treatment aspects with the counterparts in MP and also made a presentation on minute details of this infection and treatment. Experts discussed the required protocol for rational use of steroids and antibiotics, heightened monitoring of blood sugar patients and limiting secondary/hospital-acquired infections.
Indore gets first black fungus ward
Indore's MY Hospital on Wednesday started a 20-bed separate ward for black fungus patients. Now, the ward has 15 patients. Medicine Department head Dr VP Pandey said that this ward will be dedicated to black fungus patients. "A separate ward is established as these patients require experts of ENT, neurology, dental and ophthalmology departments. We saw 2-3 such cases in years but these days, this infection has surged suddenly," Dr Kamlesh Badonia said.
What experts have to say on black fungus
Senior physician Dr Rajesh Sharma said that black fungus mostly initiates in the nose and ears and as patient immunity ebbs during the Covid-19, the infection attacks the system easily. Generally, diabetic patients are prone to this infection which also reaches to jaws and the brain. Those having headache or soreness in the throat should immediately report to a doctor, advised Dr Sharma. Senior ENT specialist Dr SP Singh claimed that fungal infection increases with high levels of sugar and oxygen, so diabetic patients should control their sugar level.
Oxygen lines, humidifiers or seepage could trigger the infection
Former director of Medico Legal Institute Dr DK Satpathy claimed that hospital ICU wards, oxygen point humidifiers and oxygen lines for want of proper upkeep and cleanliness could trigger fungal infection. If the building has seepage which is not cleaned regularly, the chances of infections are high.
He claimed that smaller hospitals use a central oxygen system and several oxygen points only are used when there is an emergency and could develop fungus. Cancer, organ transplant and those with diabetes remain at high risk of infection. Those on high doses of steroids and antibiotics should be given anti-fungal doses as well.