NEW DELHI: Noting that the spread of mucormycosis is becoming a cause of concern, the Centre has advised all states and union territories to review their preparedness for prevention and control of fungal infections as well as hygiene and sanitation in hospitals.
In recent days, some states and UTs have reported an increasing number of patients suffering from mucormycosis, commonly known as black fungus.
Union Health Secretary Rajesh Bhushan has written to the Chief Secretaries and Administrators of all states and UTs, urging them to undertake activities/ practices to ensure that there are robust infection prevention and control practices in COVID-19 hospitals and other healthcare facilities.
Bhushan in his letter advised them to establish/activate the Hospital Infection Control Committee with the head of the institution or an administrator as the chairperson, designate an infection prevention and control nodal officer -- preferably a microbiologist or senior infection control nurse.
He also asked them to prepare and implement the Infection Prevention Control (IPC) Programme in the hospital/health facilities, as per the guidance given in National Guidelines for Infection and Control in Healthcare Facilities.
Transmission-based precautions need heightened focus on droplet, airborne and contact precautions from the perspective of protecting healthcare workers and ensuring patient safety, he said in the letter.
Besides, the letter stressed on the improving the environment and facilitate ventilation with focus on fresh air and natural ventilation wherever control systems with requisite air changes are not available, cleaning, disinfection and sanitation of the hospital environment and frequently touched surfaces, with recommended disinfectants like 1% sodium hypochlorite or 70% alcohol and safe water and food to prevent water or food borne diseases in hospital settings .
The letter stated that biomedical waste needs to be managed as per the CPCB guidelines available and that Infection Prevention and Control practices needs to be enhanced in Intensive Care Units (ICUs) using a bundle-approach to prevent device associated infections such as ventilator associated pneumonia or catheter-associated blood stream, urinary infections etc.
Infection prevention and control practise in the clinical laboratories and those attached to hospitals are very crucial for the safety of laboratory/hospital staff and health security of the community, the letter stated.
Meticulous adherence to infection prevention and control while managing immunocompromised patients such as COVID-19 patients on steroid treatment, with co-morbidities (such as diabetes where good glycemic control needs to be established), the letter underlined.
In due course, establish surveillance of healthcare associated infections with focus on ventilator associated pneumonia, catheter-associated blood stream infection, catheter-associated urinary tract infection, surgical site infections, gastro-intestinal outbreaks.
Train all hospital staff to develop their skills in IPC, irrespective of their individual routine duties, in implementing procedures and protocols described in the Hospital Infection Control Manual.
A State Nodal Officer needs to be identified to monitor the implementation of infection prevention and control to provide evaluation and feedback of the IPC programme in the state.
The Union Health Ministry on Friday said license has been given to five more manufactures for production of Amphotericin-B, used in the treatment of black fungus, and they will start producing 1,11,000 vials of the drug per month from July.
Efforts are being made to supplement the domestic availability of the anti-fungal drug through import, the ministry said, adding that 3,63,000 vials of Amphotericin-B will be imported in May, resulting in the total availability of 5,26,752 vials (inclusive of the domestic production) in the country.
It said 3,15,000 vials will be imported in June and along with the domestic supply, the countrywide availability of Amphotericin-B will be enhanced to 5,70,114 vials in June.
Several states and union territories have reported an increasing number of patients suffering from COVID complications in the recent days in the form of Mucormycosis, popularly known as black fungus, the ministry said in a statement.
There is also a reported shortage of Amphotericin-B, it stated.
The Union Health Ministry along with the Department of Pharmaceuticals and Ministry of External Affairs (MEA) are making proactive efforts for significantly ramping up domestic production of Amphotericin-B drug, it said.
The Union government has also made effective efforts in supplementing the domestic availability through securing supply from global manufacturers, the statement said.
The five manufacturers which have been given the license to produce the Amphotericin-B within the country are NATCO Pharmaceuticals, Hyderabad, Alembic Pharmaceuticals, Vadodara, Gufic Biosciences Ltd, Gujarat, Emcure Pharmaceuticals, Pune and Lyka in Gujarat.
These companies will start producing 1,11,000 vials of Amphotericin-B per month from July this year, the statement said.
The Union Health Ministry and department of Pharmaceuticals are together trying to proactively facilitate these five manufacturers to prepone some of this production so that these additional supplies begin in June, the statement said.
There are five existing manufacturers of Amphotericin-B in the country and one importer -- Bharat Serums & Vaccines Ltd, BDR Pharmaceuticals Ltd, Sun Pharma Ltd, Cipla Ltd, Life Care Innovations and Mylan Labs (importer).
"The production capacity of these companies was extremely limited in the month of April.
"As a result of the hand-holding by Government of India, these domestic manufactures will cumulatively produce 1,63,752 vials of Amphotericin-B in May.
This will be further ramped up to 2,55,114 vials in June," the ministry said.
Efforts are also being made to supplement the domestic availability of this anti-fungal drug through import, it said.
"In May, 3,63,000 vials of Amphotericin-B will be imported, thereby resulting in total availability in the country (inclusive of the domestic production) of 5,26,752 vials" "Besides, 3,15,000 vials will be imported in June. Hence, along with the domestic supply, the countrywide availability of Amphotericin-B will be enhanced to 5,70,114 vials in June," the ministry said.
Together, these companies will start producing 1,11,000 vials of Amphotericin-B per month from July, it added.
The Union Ministry of Health in collaboration with MEA is also actively exploring other global sources from where the Amphotericin-B drug can be imported.
The ministry is also trying to procure other anti-fungal drugs which can be used in treatment of black Fungus, the statement added.