Uttar Pradesh to assess prevalence of black fungus, draw SOP

LUCKNOW: With doctors reporting a rash of cases involving a rare infection — Black Fungus — among recovering and recovered Covid-19 patients, the UP government on Wednesday directed health and medical education departments to coordinate with the advisory committee on Covid-19 to chalk out a report on the status of such cases in the state.
During the pandemic review on Wednesday, chief minister Yogi Adityanath said, “Team 9 constituted under the chairmanship of chief secretary R K Tiwari should consult the state-level advisory panel of health experts on prevelance of Black Fungus infection.”
Additional chief secretary, information, Navneet Sehgal, said: “The committee has also been tasked to develop a line of management for prevention and a standard operating protocol for treatment." Black Fungus is the common name for a fungal infection called mucormycosis.
On Monday, Indian Council of Medical Research (ICMR) expressed concern about a surge in such infections among Covid patients, diabetics, immunosuppressed patients (persons whose immunity levels have declined) and those who had a prolonged stay at intensive care units. “Mucormycosis may turn fatal if uncared for,” the ICMR advisory said. Seven cases of black fungus are being managed at Lucknow’s King George’s Medical University and four patients were flagged by the Meerut health administration. Prior to the ICMR advisory, such cases were first reported in Gujarat and Maharashtra.
Physicians are of the view that non-judicious use of steroids in patients with co-morbid conditions may also predispose conditions that allow development of Black Fungus.
“Steroids tend to cause a kind of immunosuppression, which is a known predisposing factor of black fungus,” said Dr Sunil Verma, a senior consultant in internal medicine. He added excess or mindless use of steroids can be detrimental while treating Covid or pneumonia.
The ICMR advisory stated that warning signs should not be ignored in the vulnerable group. “Sinusitis, nasal blockade or congestion, nasal discharge (blackish/bloody), local pain on the cheek bone, one sided facial pain, numbness or swelling, blackish discoloration over bridge of nose/palate, toothache, loosening of teeth, jaw involvement, blurred or double vision with pain; fever, skin lesion; thrombosis and bedsores (necrosis (eschar), chest pain, pleural effusion, hemoptysis (coughing blood), worsening of respiratory symptoms are warning signs that must be taken seriously and dealt with,” it said.