After Rajasthan, Telangana declare ‘black fungus’ as epidemic, Centre asks all states to follow suit

After Rajasthan and Telangana governments declared mucormycosis or black fungus as an epidemic after its cases began to rise, the Union Health Ministry has sent out a letter to all states asking them to make mucormycosis a notifiable disease under the Epidemic Diseases Act 1897.

The letter signed by Lav Agarwal, joint secretary in the Ministry of Health and Family Welfare, states that all government and private health facilities will follow guidelines issued by the ministry and ICMR for screening and management of mucormycosis, in addition to reporting all suspected and confirmed cases to the health department through district level Chief Medical Officers.

The letter states that the fungal infection mucormycosis is affecting COVID-19 patients especially those on steroid therapy and deranged sugar control. “This fungal infection is leading to prolonged morbidity and mortality amongst COVID-19 patients. The treatment of this fungal infection required multidisciplinary approach consisting of eye surgeons, ENT specialists, general surgeons, neurosurgeons and dental maxilla facial surgeons and the institution of Amphotericin B as an antifungal infection,” the letter said.

People with diabetes and obesity often have severe COVID-19 symptoms, which mean they're more likely to receive corticosteroids, which are frequently used to treat COVID-19. But the corticosteroids – along with diabetes – increase the risk of mucormycosis.

It appears as a side effect among COVID-19 patients who are put on oxygen support through liquid medical oxygen.

When diabetes is poorly controlled, blood sugar is high and the tissues become relatively acidic, which makes it a favourable environment for mucorales fungi to grow.

Formerly known as ‘zygomycosis’, this fungi is usually found in the environment and is associated with decaying organic material such as fruit and vegetables.

The disease can spread to the eyes, in all likelihood causing blindness, or to the brain, causing seizures and severe headaches. In most of the cases, the patients have died or sustained severe damage to their health.

This is one of the reasons why the disease must be diagnosed and treated in the early stages.

On Wednesday, the Rajasthan government declared mucormycosis an epidemic and a notifiable disease, making it mandatory for the health facilities to report every case of the disease in the State. Rajasthan has more than 100 black fungus patients, who are being treated in a special ward at the Sawai Man Singh Government Hospital in Jaipur.

On the same day, Telangana government had also declared it as an epidemic.

Gujarat, Maharashtra, Madhya Pradesh, Delhi, Uttar Pradesh and Uttarakhand have also witnessed a sharp rise in black fungus cases.