Centre taking steps to ramp up production of anti-black fungus drugs as cases rise

Talks are on with manufacturers of the drug to raise its availability and the supply position is expected to improve with extra imports of the medicine and increase in its production domestically.
Relatives of Covid patient interact with health worker outside the State Government run Covid hospital in Kolkata. (Photo | PTI)
Relatives of Covid patient interact with health worker outside the State Government run Covid hospital in Kolkata. (Photo | PTI)

NEW DELHI/MUMBAI/PATNA/RANCHI/CHANDIGARH/BHOPAL: An alarming rise in the deadly fungal disease mucormycosis in patients recovered from Covid in several states has prompted the Centre to take steps for ramping up the production of amphotericinB, an injectable medicine used to treat the condition.

Mucormycosis, a rare infection also known as black fungus disease, is normally caused after exposure to mucor mould commonly found in soil, plants, manure, and decaying fruits and vegetables but is being reported in people following recovery from Covid.

The condition, with an overall mortality rate of over 50%,  affects the sinuses, the brain, eyes and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals such as cancer patients or people with HIV.

A large number of people, who have recovered from Covid in India, are now reporting this disease, as it gets triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients which is given to suppress the immune response against the virus.

Doctors say mucormycosis primarily affects those with a history of diabetes or immunocompromised individuals and of late there has been a worrying rise in the number of such patients.

Recognising the need to prioritise treatment of such patients, the Centre on Tuesday allocated amphotericinB among states based on supplies available till the end of this month.

The Union government also said that talks are on with manufacturers of the drug to raise its availability and the supply position is expected to improve with extra imports of the medicine and an increase in its production domestically.

States have also been urged to put in place a mechanism for equitable distribution of supplies between government and private hospitals.

States already grappling with the huge challenge posed by Covid, on the other hand, are on the brink with the rising instances of mucormycosis cases.

In Maharashtra, for instance, there are over 2,000 mucormycosis patients while 8 patients have already succumbed to the fungal infection.

“We are setting up special wards to treat fungal infected patients. We also urgently need one lakh injections that are effective on this mucormycosis. We have registered our demand with Haffkine Institute of Training and Research and they will soon float the tender to purchase these injections,” said Health Minister Rajesh Tope. 

He added that patients with mucormycosis will be given free of cost treatment under the Mahatma Jyotibha Phule health scheme in 1,000 hospitals across the state.

In Jharkhand, over 35 cases have emerged so far with a 38-year-old patient undergoing a procedure to remove one of his eyes.

This patient was the first recorded case of the disease in the state, said Dr Anindya Anuradha at Medica Hospital in Ranchi and there are four others with severe damage to their eyes due to the disease.

At PGI, Chandigarh a rise of 35% in cases of mucormycosis has been noted in one year. Doctors said that a total of 61 cases of the disease have been seen at the tertiary care centre since April 2020, 59 of whom had surgeries for partial or full removal of their eyes, and those without Covid recovered faster.

Annually, around 45 such cases used to come before the pandemic, said PGI sources.

At least 50 cases of this deadly disease have also been reported in Madhya Pradesh, according to CM Shivraj Singh Chouhan.  

“We’re developing a detailed protocol, which will include its causes, symptoms and treatment strategy. All patients infected with black fungus will be treated as per the protocol only. Since the injections used to treat this infection are costly, the government will ensure free treatment of economically weak patients of the infection at our government hospitals,” Chouhan said in Bhopal on Wednesday.

 Sources said that black fungus cases have mostly been reported among post-Covid patients in Indore, Bhopal and Jabalpur. Keeping in mind the rising cases, a dedicated Mucormycosis unit of 10-beds each is being created at the Netaji Subhash Chandra Bose Medical College in Jabalpur and Gandhi Medical College in Bhopal in the first phase.

At Jabalpur Medical College, dean PK Kasar confirmed that two such patients have undergone surgery.

The disease has also been detected in four persons in Bihar so far. These four Covid patients, with a history of diabetes, are currently under treatment at AIIMS and the Indira Gandhi Institute of Medical Science in Patna.

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