Over the last few weeks, there has been a steady rise in mucormycosis cases, prompting fresh alarm in India. Against this backdrop, the Indian Medical Association HQ has released a list of guidelines outlining the management, treatment and preventive measures that can be taken.
Various states have reported a manifold spike in cases of what is being called 'black fungus' with some patients even passing away after being affected. In Delhi's AIIMS for example, officials recently said that around 20 cases were being reported on a daily basis. Some states, including Telangana have also made mucormycosis a notifiable disease under the Epidemic Diseases Act 1897.
But with hundreds of cases being recorded, new problems have emerged. While local authorities in Pune have directed health officials to screen COVID-19 survivors in rural areas to identify suspected cases, hospitals in Bhopal have now been left floundering as they run out of Amphotericin B injections. This drug incidentally is used to treat patients who develop the illness while undergoing treatment for COVID-19.
According to the AIIMS document, it is caused by fungus rhizopus and mucor of the order mucorales mainly and infection occurs after individuals inhale ubiquitous spores. While there is no age or gender predilection, factors such as uncontrolled diabetes mellitus, comorbidies or immunosuppression by steroids can make it easier to get infected. Factors such as reuse of face masks or oxygen tubing can also contribute.
According to the IMA there are several symptoms that one should be on the look out for. This includes nasal blockage or discharge, facial pain, numbness and redness around eyes and/or nose, sinus tract on face, fever, one sided facial pain, blackish discoloration over bridge of nose or palate, toothache or loosening of maxillary teeth, blurred or double vision and more.
The IMA document also shares a lengthy list of guidelines for management and medical treatment of the infection - from tests that can be run to drugs that can be administered by health workers. They also shared a list of do's and don'ts, presumably for doctors to follow.
