3,200 cases of black fungus recorded in Maharashtra: State government to HC

MUMBAI: The Maharashtra government on Thursday informed the Bombay High Court that the state has so far recorded 3,200 cases of mucormycosis, also known as black fungus, a serious infection being found in COVID-19 patients.

As against Maharashtra's requirement of 14,000 vials per day, the state was receiving only 4,000 to 5,000 doses each day, the state's counsel, Advocate General Ashutosh Kumbhakoni, told the court.

He said there were "very few" manufacturers of anti- mucormycosis drugs and injections, hence there was a shortage across the country.

"There are 3,200 cases of mucormycosis as of now in the state. Mucormycosis has been declared a notified disease, so when the health-care establishment receives a patient, they have to inform public health officials, so at the state-level we can have complete data of patients," he told the HC.

As the data available on May 26, Mumbai has recorded 335 cases of mucormycosis so far, the state informed a bench of Justices Amjad Sayyad and G S Kulkarni.

The bench was hearing a bunch of public interest litigations (PILs), seeking proper management of issues related to the COVID-19 pandemic.

Kumbhakoni and the Brihanmumbai Municipal Corporation's (BMC) advocate, senior counsel Anil Sakhre, informed the court that they were keeping records and maintaining data of such cases.

The state also said it had developed an online portal to maintain records of mucormycosis cases and medicines available for the infection.

Kumbhakoni said there were "very few" manufacturers of anti-mucormycosis drugs and injections, hence there was a shortage across the country.

The Centre has identified only three manufacturers to produce anti-mucormycosis injections, he said, adding a patient on an average requires four to five vials per day.

As against Maharashtra's requirement of 14,000 vials per day, the state was receiving only 4,000 to 5,000 doses each day, Kumbhakoni said.

The state had tied-up with the Haffkine Pharma to manufacture the drug in the state to meet the demand, he said.

"Maharashtra has started in-house manufacturing of anti-mucormycosis injections. It takes 20 days to have the finished product. We completed the procurement of raw material on Wednesday," Kumbhakoni said.

By June 6, the state should have a comfortable demand-supply position, he said.

The Union government's counsel, Additional Solicitor General Anil Singh, told the HC that the Centre had issued a detailed advisory on prevention, and dos and don'ts for mucormycosis.

"An expert task force is working on this. The states most affected by the black fungus are Maharashtra, Karnataka and Gujarat. The supply of injections to these states will be increased by mid-June," Singh said.

Several factors, such as co-morbidities, low immunity and indiscriminate use of steroids were resulting in the rise in cases of mucormycosis, he said.

The HC then suggested that the Centre issue a protocol on prescription and use of steroids for treating COVID-19.

"We want a protocol as there is an indiscriminate use of steroids," the bench said.

The court also directed the state government and BMC to use technology to improve the condition of crematoriums and to construct more electric and gas crematoriums.

"What about facilities, technology, electric crematoriums, handling the bodies in a scientific manner?" the HC asked.

The court directed the state to inform it about the steps being taken in the matter on the next date of hearing.

"Fortunately, we do not have incidents like other states where bodies are floating in the Ganga (river)," Kumbhakoni said.

"Not a single person has been denied a decent burial or cremation in the state on account of lack of space," he said.

The high court will continue the hearing on June 2.