Misfortunes never come singly!
Recently, there has been a rapid increase in cases of mycosis infection among COVID-19 patients in India.
As of May 22, 8,848 cases of Mucor infection had been reported across India and 212 people had died, according to figures cited by Indian media.
Just two weeks ago (9 May), only about 300 people in India had been infected with the disease.
According to reports by India Today, NDTV and other Indian media, the medical community in India has yet to reach a final conclusion on the cause of the infection. However, doctors who collected patient data found that most of the infected patients were male, had used steroids during Coronavirus treatment, and most of them had underlying diabetes.
Dr. Vinod Kumar Paul, a medical expert and member of the Indian think tank NITI Aayog, said today (May 22) that the surge in cases of mycormyosis can be attributed to the disproportionate use of steroids in the treatment of COVID-19 patients.
Earlier, India’s Ministry of Health reiterated the importance of “strict adherence” to infection prevention and control practices and urged all regions to strictly control the spread of trichomycosis in hospitals.
Several Indian states, including Rajasthan, Uttar Pradesh, Orissa and Gujarat, have declared Mucormycosis a statutory epidemic.
Screenshot of the report showing more than 8,800 cases of mycosis in India
Immunity low population, easy to infect mycosis
According to Indian doctors and specialists, mucormycosis (Black Fungus) as the “epidemic” of epidemic, by “hairy mould fungi that exist in the natural environment, its symptoms as headache, nasal bleeding, coughing up blood, facial numbness and swelling, blurred vision, breathing difficulties, severe cases may also cause maxilla damage and even blindness.
Experts said Mucormycosis usually “does not pose a significant threat” to people with normal immune systems, but some people are more vulnerable because they have been taking immunosuppressant drugs for a long time for health problems and are less able to fight pathogens in the environment.
Mucormycosis mainly affects arteries and blood vessels, causing thrombosis and necrosis, vision problems, chest pain and breathing difficulties.
In severe cases, the mortality rate of Mucormycosis exceeds 50%.
The treatment of trichomycosis needs to race against time and adopt a multi-pronged approach.
Once a fungal lesion is diagnosed, surgical volume reduction, such as orbital resection or intracranial decompression, must be performed immediately to remove all fungus and necrotic tissue;
In the meantime, patients are given daily intravenous injections of anti-fungal drugs for eight weeks.
“It (Mucormycosis) is everywhere, in the soil and air, even in the noses and mucus of healthy people.
Dr. Akshay Nair, an ophthalmologist in Mumbai, said the body’s defenses keep Mucor out, but when the immune system is weakened, the fungus can take advantage.
The Indian Express counted several conditions that lower a person’s immune system: diabetes, steroid use, hematological malignancies, immunosuppressant use, excessive iron or ferriamine use, trauma, burns and malnutrition.
A patient with Mucormycosis after surgery, pictured from India
There were 8,848 cases of Mucormycosis infection and there was a shortage of drugs
The total number of cases has reached 8,848 and 212 people have died, with 2,281 cases in Gujarat, the worst-hit state, the minister said Monday.
Just two weeks ago (9 May), only about 300 people in India had been infected with the disease.
Guda added on Twitter that the government had sent more than 23,000 vials of key drugs for treatment to the affected states “following a detailed review of the rising number of infections everywhere” in light of the rapid increase in cases of Mucormycosis.
Earlier, the Ministry of Health reiterated the importance of “strict adherence” to infection prevention and control practices, requiring all regions to strictly control the spread of the disease in hospitals and declare it a statutory epidemic.
Indian Prime Minister Narendra Modi also stressed that Mucormycosis is a life-threatening fungal infection and all measures must be taken to prevent it during an online meeting with some of the frontline health care workers on Tuesday.
As of now, Rajasthan, Uttar Pradesh, Orissa, Gujarat and many other states have declared Mucormycosis a statutory epidemic.
Tweets screenshots
Separately, the BBC (BBC) reported on the 23rd that the emergence of cases of Mucor infection has added to the overcrowding of medical resources across India due to the COVID-19.
At a 1,100-bed state hospital in the central Indian city of Indore, the number of patients infected with Mucor had jumped from eight a week earlier to 185 on Tuesday evening.
Dr VP Pandey, the hospital’s medical director, told the BBC that more than 80 per cent of these patients required immediate surgery.
Dr. Pandey said the hospital has set up 11 wards with a total of 200 beds to treat patients with Mucor.
He said: “The spike in the number of patients was absolutely unexpected.
We’ve only seen one or two cases in the past year.”
He estimates that Indore alone has at least 400 patients.
“Currently, Mucor infections are more challenging than Novel Coronavirus.
If patients do not receive prompt and proper treatment, the mortality rate can be as high as 94 percent.
Treatment is expensive and medicines are in short supply.”
The Times of India reported on Wednesday that hospitals across India were experiencing shortages of the antifungal drug amphotericin B.
Screenshots of a shortage of mycosis drugs in India
Use of steroids to treat coronavirus may cause increase in cases, Indian expert says
At present, the medical community in India has not reached a conclusion about the cause of the infection.
But some doctors say the use of steroid drugs to treat patients with severe COVID-19 may be one reason for the surge in cases of mycosis, as the drugs can reduce immunity.
Dr Pandey, from the Indian city of Indore, told the BBC he had collected data from 201 patients at four hospitals in the city.
The patients, mostly men, appear to have developed symptoms of infection within 12 to 18 days of recovering from COVID-19, Dr. Pandey said.
Most of them had used steroids during Coronavirus treatment and all had underlying medical conditions, mainly diabetes.
The BBC cited two other studies by doctors in India: one that looked at more than 100 patients with Mucormycosis, 79 of whom were men, and 83 with diabetes;
Another study looked at 45 patients with mycosis, all of whom had diabetes.
“None of the patients with Mucormycosis have normal blood sugar.”
“Akshay Nayar, an Indian ophthalmologist, told the BBC.
Dr. Vinod Kumar Paul, a medical expert, said the spike in Mucor cases can be attributed to the disproportionate use of steroids in the treatment of COVID-19 patients at a press conference held by NITI Aayog, an Indian think tank, on Wednesday.
A doctor is diagnosing a patient with mycosis. Photo taken in print
Meanwhile, medical experts in India have also suggested that the government should look into other reasons behind the surge in cases of Mucor in parts of the country.
Professor Giridhar Babu, head of life process epidemiology at the Public Health Foundation of India, said: “There are several hypotheses, but the most likely is that it is multifactorial in nature: perhaps the availability of medical oxygen, or the presence of comorbid diseases.”
Two weeks ago, Professor K. Srinath Reddy, chairman of the Public Health Foundation of India, said in an interview that the recent spike in cases of the disease could be caused by inhalation of contaminated water.
“More patients need oxygen this time,” he said at the time.
Many patients use oxygen concentrators at home, and if the water is slightly contaminated, there is a risk of fungal infection, especially for those with weakened immune systems.”
In addition, Mucor exists on wet surfaces, so “patients should make sure the humidifier is waterproof when receiving oxygen support (to prevent the growth of the fungus),” Maffat, head of the department of otolaryngology at a public hospital in Mumbai, warned.