The Union Health Ministry on Friday issued guidelines for prevention and treatment of Mucormycosis as it took stock of an alarming increase in recovered Covid-19 patients being forced to return to hospitals with cases of the deadly fungal infection also known as the “black fungus”.
Health experts have advised that the infection is more likely in Covid-19 patients with acute diabetes being treated with an excessive amount of steroids, which weakens the immune system. The disease is likely to kill about half the patients it infects, according to available medical data, but medical experts have said that chances of survival can be increased by early detection and proper care.
The Indian Council of Medical Research (ICMR) has said treatment includes weeks of intravenous antifungal therapy and involves surgically removing all dead and infected tissue, which could lead to the removal of the upper jaw or sometimes even the eye. The ICMR has also advised capping the use of Tocilizumab, a drug that suppresses the immune system.
Symptoms of the illness include pain and redness around eyes or nose, fever, headache, coughing, shortness of breath, blood while vomiting and altered mental status. Patients with uncontrolled diabetes, immunosuppression by steroids and prolonged stays in the ICU, with co-morbidities or treated with antifungal medication like Voriconazole are more likely to contract the infection.
The ICMR advised using masks while visiting dusty construction sites, wearing shoes, long trousers, long sleeve shirts and gloves while gardening, moss or manure and to maintain personal hygiene including thorough scrub baths to stave off the infection.
Here are a list of dos and don’ts as per the ICMR guidelines:
Dos
1. Control hyperglycemia or high blood sugar levels
2. Keep an eye on blood glucose level post Covid-19 discharge and also in diabetics
3. Judicious use of steroid: correct timing, correct dose and duration
4. Use clean, sterile water for humidifiers during oxygen therapy
5. Use antibiotics/antifungals judiciously
Don’ts
1. Do not miss or ignore warning signs and symptoms
2. Do not consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on drugs that weaken the immune system
3. Do not hesitate to seek “aggressive” investigations, as directed by medical experts (KOH staining & microscopy, culture, MALDI- TOF), key for detecting the infection
4. Do not lose crucial time to initiate treatment for mucormycosis
Union Health Minister Harsh Vardhan also tweeted a handy infographic on the guidelines for Mucormycosis: