Tamil Nadu has fourth-highest number of black fungus cases

MADURAI: Tamil Nadu stands fourth among the states with highest number of Mucormycosis cases, revealed a data issued by the Union Ministry of Health and Family Welfare in the Parliament. According to the data, Maharashtra stands first with 9,654 cases as on July 28 this year, followed by Gujarat with 6,846 cases, Andhra Pradesh with 4,209 cases and Tamil Nadu with 4,075 cases. 

Mucormycosis or Black Fungus disease, although not a new disease, was not a notifiable disease till May 2021 when Ministry of Health & Family Welfare requested states to declare it a notifiable disease under Epidemic Disease Act, 1897 to get an objective assessment of Mucormycosis in the community. 

Mucormycosis has been found to be causally associated with hyperglycemia (due to new onset or pre-existing diabetes or steroid induced), irrational use of broad-spectrum antibiotics, co-morbidities such as hematological malignancies and use of immuno suppressants. Black Fungus cases being reported by the States/UTs peaked in the later half of May 2021 and are now showing a declining trend, said the ministry.

The ministry said that clinical guidance on diagnosis and management of diabetes at Covid patient management facility, a detailed advisory on treatment and management of Covid associated Mucormycosis,  a checklist for managing Mucormycosis and other fungal infections were  issued to the States/UTs between June 1 and June 11 this year. Further noting the relationship between use of steroids and other immune-suppressive drugs “Advisory for rational use of Steroids and Tocilizumab in the treatment of Covid  patients” was issued by the Directorate General of Health Services.

Since early May, 2021 the ministry said that it has obtained details of production, stock, supplies made and purchase orders from the manufacturers and their co-operation was sought to overcome the gap between supply and demand. “Both first- and second-line drugs used for managing Mucormycosis cases -  Amphotericin B Deoxycholate and Posaconazole, are currently amply available.  

The Department of Pharmaceuticals (DoP), Central Drugs Standard Control Organisation (CDSCO) and National Pharmaceutical Pricing Authority (NPPA) have been jointly monitoring the production and availability of critical drugs including Amphotericin-B injections.  Besides the existing five manufacturers, DCGI had issued permission to manufacture/ market Amphotericin B to six additional firms,” said the ministry.