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Mucormycosis: 2,245 cases so far in Maharashtra, 30 dead in last six days

Maharashtra, meanwhile, continues to reel under shortage of Amphoterecin B injection, an anti-fungal medication needed for treatment of the disease, also referred to as Black Fungus.

Written by Tabassum Barnagarwala | Mumbai |
May 26, 2021 3:09:58 am
A patient being checked for signs of mucormycosis in Navi Mumbai on Tuesday. (Photo: Amit Chakravarty)

The number of reported cases of Mucormycosis in Maharashtra has risen from 1,500 last week to 2,245 on Tuesday, officials said, attributing the increase to districts finally notifying all cases to the government.

The state, meanwhile, continues to reel under shortage of Amphoterecin B injection, an anti-fungal medication needed for treatment of the disease, also referred to as Black Fungus.

So far, 213 Mucormycosis patients have recovered and been discharged from hospitals across Maharashtra, while 120 people succumbed to the infection linked with Covid-19. Of these deaths, 30 were reported in the last six days.

With 284 cases, Nagpur has reported the highest number of cases in the state, health officials said, adding seven deaths have been reported from the district. Mumbai, meanwhile, recorded the highest number of deaths (21) and 100 cases. The high number of deaths is due to critical patients from other districts being referred to the state capital, said an official.

Districts have been asked to notify new mucormycosis cases on Integrated Disease Surveillance Programme (IDSP) portal so that the Central Government can allot Amphoterecin B to the districts based on the number of cases reported there.

Maharashtra expects to procure 60,000 vials of Amphoterecin B by June 1 through a global tender. Health minister Rajesh Tope said the state expected the supply to improve slightly by next month.

The Centre first allotted 16,500 vials to the state, and later added 5,090 vials in its quota till May 31. With 2,245 patients, each requiring 100 vials on an average, the state immediately needs 2.24 lakh vials of the drug.

“The next few days, we may see a shortage of the drug everywhere. We are also asking the Centre to increase our allocation,” Tope said.

Each Liposomal Amphoterecin B injection costs Rs 6,000-8,000; in black market the price is five to six times higher. Each patient requires 90-120 injections, and if the treatment stretches up to three to four weeks, the cost of the drug alone can go up to Rs 6-8 lakh.

While Amphoterecin B is considered most effective in the infection, it is also the most expensive treatment option. Alternatives to it are Amphoterecin B deoxycholate, or other anti-fungal medicines such as Isavuconazole and Posaconazole.

Maharashtra has announced free treatment for the rare fungal infection that is now being commonly seen in Covid-19 patients, both in active cases and in those who have recovered two to four weeks back.

The treatment is free in all government hospitals and hospitals empanelled with Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) – a state government scheme. Officials said even if treatment cost rises beyond the ceiling price of Rs 1.50 lakh set under the scheme, the state government would bear the expenses.

As of Tuesday, 1,007 patients of Mucormycosis were admitted in MJPJAY hospitals in Maharashtra.

Dr Sudhakar Shinde, chief executive officer of MJPJAY, said 131 hospitals empanelled with the scheme have agreed to treat Mucormycosis patients. “Not every hospital has specialisation to treat such patients,” he said.

The treatment can require surgical intervention to remove the fungus, apart from anti-fungal medicines. A specialised team of plastic surgeons, ophthalmologists, ENT (ear, nose and throat) specialists, neurologist, anaesthetists and general surgeons are required for treatment.

Data shows the fungal infection is being reported among hospitalised as well as home-isolated patients.

Asked about causes of the infection, Dr Avinash Supe, chairman of the death audit committee, said, “We still don’t know the exact reasons behind it. We need to study the role of oxygen, steroids, immunity and diabetes. Right now, we are assuming based on present evidence.”

Although, Mucormycosis in patients with Covid-19 is of relatively less severity as compared to cases seen before the pandemic, Dr Supe added.

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