Mucormycosis

Guwahati, May 26: Amidst the COVID-19 pandemic, the Assam government on Wednesday declared the ‘Black Fungus’ infection also known as Mucormycosis as a notified disease.

The decision of declaring Mucormycosis as a notifiable disease under Section 2 of the Epidemic Diseases Act, 1897 has been taken by the Ministry of Health & Family Welfare.

The decision was taken after a suspected case of Mucormycosis was detected in a hospital in Assam, while a large number of similar cases have been reported from other parts of the country. Moreover, such cases have a significant risk of mortality with an additional likelihood of an increase in the number of such cases soon.

The statement further said, “All Government and Private Health facilities, Medical Colleges will follow guidelines for screening, diagnosis, management of Mucormycosis, issued by the Ministry of Health & FW, Govt of India and Indian Council of Medical Research (ICMR)”.

“It is hereby made mandatory for all the health facilities, both Govt and private, and Medical Colleges to report all suspected and confirmed cases to the Health & FW Department at the district level via concerned Joint Director of Health Service and subsequently to IDSP (Integrated Disease Surveillance Project) surveillance system,” the order said.

What is Black Fungus?

According to the Union Health Ministry, mucormycosis is a fungal infection that mainly affects people who are on medication that reduces their ability to fight environmental pathogens. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from air and it may turn fatal if not cared for. While it is very rare, it can lead to loss of the upper jaw and sometimes even the eye. Warning signs include pain and redness around the eyes and/or nose, fever, headache, coughing, shortness of breath, bloody vomit, and altered mental status.

Last week, Assam Health and Family Welfare Department released a Standard Operating Procedure (SOP) to contain the possible spread of the disease.

The orders issued by the principal secretary to the Assam governments Health Department said, a large number of similar cases have been reported from other parts of the country, and there is a likelihood of an increase in the number of such cases in the future.

“In order to screen, diagnose and manage such cases of black fungus in COVID patients, the Standard Operating Procedure is notified with immediate effect,” it said.

The SOP contains details about symptoms, management of COVID-19 patients with black fungus infection and advisory for the general public, and treatment protocols. Elaborating on black fungus infection, mucormycosis is a rare serious fungal infection caused by ungus Mucor.

People can be infected with black fungus by coming in contact with its spores in the environment. It can also develop in the skin after the fungus enters the skin through a cut, abrasion, burn, or other types of skin trauma, the advisory said.

People who have uncontrolled diabetes mellitus, and immune-suppressed patients, those in ICU for a prolonged period, people with HIV or malnutrition, and those on steroids for medical cause need to be careful if they develop nasal blockage, facial or cheekbone pain, blackish and foul-smelling nasal discharge, congestion or redness and swelling of eyes and nose, and difficulty in vision.

The other symptoms are headaches and fever, seizures, altered mental state, cough, blood-stained sputum, shortness of breath with worsening respiratory problems, toothache, loosening of teeth, and blackish discoloration in the skin with Necrosis (death of cells or tissue through disease or injury).


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The guidelines issued to prevent black fungus in COVID-19 patients suggested better control of the sugar levels during COVID with or without steroids, judicious use of steroids observing correct timing, correct dose, and correct duration, use of clean or sterile water for humidifiers during the oxygen therapy.

People were urged to use masks while visiting dusty construction sites, wear shoes, long trousers, long sleeve shirts, and gloves while handling garden soil, moss or manure, maintaining personal hygiene, and seeking immediate medical attention in case they develop the symptoms.