Assam detected the first black fungus or mucormycosis infection in a Covid patient who died in a private hospital here recently. But according to health department sources, similar cases might have gone unreported, especially during the second wave, which has increased chances of more black fungus cases due to prolonged stay in the ICU.
“Such cases (mucormycosis infection) have significant risk of mortality and there is a likelihood of an increase in the number of such cases in the near future,” read the notification issued by the state health department on Wednesday.
The state health department issued the directive in pursuance of a letter from the Union ministry of health and family welfare under Section 2 of the Epidemic Diseases Act, 1897. Now all hospitals and medical colleges will have to follow the same guidelines for screening, diagnosis and management of mucormycosis, issued by the Union health ministry and the Indian Council of Medical Research (ICMR).
“It is hereby made mandatory for all health facilities, both government and private, and medical colleges to report all suspected and confirmed cases to the health and family welfare department at the district level via the concerned joint director of health services and subsequently to the IDSP surveillance team,” said the notification.
Assam National Health Mission director, Dr Lakshmanan S, told TOI that at this point, the black fungus situation is not worrisome in Assam but a high alert must be sounded. Lakshmanan said that the Assam government has proactively issued clear guidelines for identification and management of the black fungus infection and declared it as a notifiable disease so that not a single case is missed.
“A patient’s immunity may be affected by the virus or because of steroid and monoclonal antibodies given to him. There is a possibility that the black fungus (mucormycosis) infection might occur and we should be very careful of the early signs,” he added.
Though the only 27-year-old man from Assam succumbed to Covid-related complications after black fungus was detected on him, health experts said that such fungal infection was reported earlier also in Assam. “Since it was a case of black fungus on a Covid patient, who was recovering, the government has taken it very seriously. But fungal infection has been common among patients in ICU for some time,” said Assam director of medical education, Dr Anup Kumar Barman.
Health officials said that there is sufficient stock of antifungal medicines in the state but the only worry is the unreported cases, if any. A senior health practitioner said high diabetic, cancer patients, those suffering from kidney failure and patients who have undergone organ transplantation have low immunity levels and thus, face a risk of fungal infection. “Black fungus does not spread from one person to another. The fungus is there in the atmosphere or in the healthcare facility. One needs immunity to fight it,” a health expert said.