The GOI on Thursday directed all the states and union territories to declare Mucormycosis, or commonly called "Black Fungus", as an epidemic. This comes in after India began to show some resolve in its fight against the ongoing devastating second wave of Covid-19.

Earlier this month, NITI Aayog cautioned the people of Black Fungus, but seeing the rise in number of cases, the Central Government urged its state counterparts to declare the fungal disease a ‘notifiable disease under the Epidemic Diseases Act 1897’.

According to the letter issued by the Union Health Ministry, it has asked the states to declare the fungal infection a notifiable disease wherein it requires all government & private health facilities, and medical colleges to follow the guidelines issued by the Ministry and the ICMR for screening, diagnosis, and management of the disease.

The move also necessitates the facilities to report all suspected and confirmed cases through the district-level chief medical officer, and, subsequently, to the Integrated Disease Surveillance Programme (IDSP).

The Ministry justifies the direction keeping in mind an increase in the number of reported ‘black fungus’ cases in post-Covid complications which prolonged morbidity and mortality among patients infected with SARS-CoV-2. The Ministry also noted that the rare fungal infection is more specifically seen in Covid-19 patients who are either receiving steroid treatments or have uncontrolled diabetes.

The ICMR had started tracking black fungus cases since May 15, however the exact case burden is not known, but with this move which mandates district level reporting of all cases, a clearer and more precise picture is expected to come about.

Hindustan Times reported on Friday that around 7,250 people have been infected with the fungal disease, and the infection has taken 219 lives. Maharashtra is the most affected by Mucormycosis with 1,500 cases and 90 deaths. This is closely followed by Gujarat, and then Madhya Pradesh, both having over 500 cases, and 61 and 31 deaths respectively.

Beyond these 10 states, reports of suspected Black fungus cases have also cropped up in Punjab, West Bengal, Andhra Pradesh, Jammu Kashmir, and Rajasthan.  

After the dawn of Black Fungus cases, the governments of Tamil Nadu, Rajasthan, Odisha, Telangana, Assam, Punjab and Delhi on Thursday declared Black Fungus or Mucormycosis as a notifiable disease in accordance with the Central government’s request. 

What some states are doing?

Few Governments have been more proactive in dealing with the new health concern.

Arvind Kejriwal tweeted that centres for the treatment of Black Fungus will be set up at Lok Nayak Jai Prakash Narayan Hospital, Guru Tegh Bahadur Hospital, and Rajiv Gandhi Super Speciality Hospital.

Madhya Pradesh Chief Minister Shivraj Singh Chouhan has directed to set up a dedicated task force comprising the health minister, medical education minister, ENT experts, and additional chief secretaries/principal secretaries of the departments concerned for making arrangements for the treatment of black fungus.

In Telangana, a government ENT Hospital has been designated as a nodal centre for admitting and treating Black Fungus cases.

Concerns regarding the medicine used for treatment

The rare fungal disease requires a multi-disciplinary approach for its treatment consisting of eye surgeons, ENT specialists, general surgeons, neurosurgeons, and dental maxillofacial surgeons, among others, and the Amphotericin-B injection as an antifungal medicine.

Posts regarding shortage of the Amphotericin-B injections has flooded the social media with SOS calls for the injection in the last few days.

The supply is expected to meet the demand as 5 companies have been approved for the production of Amphotericin-B which will now work with the 6 pharma companies that already produce it. Together these companies are working towards boosting production.

Indian companies have also placed orders to import 6 lakh vials of the injection to counter the shortage, said Mansukh Mandaviya, the Union Minister of State for Chemicals and Fertilisers.

Amidst an already dangerous Covid-19 pandemic, the Black Fungus only comes as a dark cloud dimming the rays of hope, but effective communication and efficient implementation of resources can help control this fungal disease before the situation gets any worse.

The Centre has asked the states to notify the public health network as soon as a case is reported, so that resources can be consolidated, and all guidelines can be followed to effectively combat it.

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This article is written by Supratik Mitra