The Nagpur Bench of the Bombay High Court said that mucormycosis or “black fungus” was no longer a rare disease in the city and had “assumed a form of an epidemic”, reported PTI. The court therefore ordered the central and the Maharashtra government to take all measures to ensure sufficient stock of medicines was available.
Justices SB Shukre and AG Gharote made the observation during the hearing of a bunch of pleas related to the Covid-19 pandemic. The court cited the data in the affidavit filed by the Indian Medical Association to assert that the fungal infection was not a rare infection anymore.
The court also ordered the Centre and states to take immediate steps to boost the production of anti-fungal drug liposomal amphotericin B, a drug used to treat mucormycosis or “black fungus”. “Whatever help is needed by them [manufacturers], must be made available forthwith,” it said.
The raw materials used for manufacturing the drugs amphotericin B (Lipid Complex) and amphotericin B (Liposomal) are largely imported, the court noted. It added that effective steps related to the imports would help India tackle “black fungus” cases.
As of May 29, a total of 1,584 patients are suffering from mucormycosis in Nagpur. Of these, 830 have gone through surgeries, the court said, citing the data submitted. So far, 69 patients succumbed to the disease, reported PTI.
The Centre told the court that expected production from the existing five manufacturers was likely to increase in June to 2,55,114 vials, of which 1,02,000 more vials are expected to be produced in June alone. A patient infected with “black fungus” needs six vials a day.
“However, it is not known as to how many and how these allocations have been made, whether randomly or by considering the caseload in Maharashtra,” the court said. After this, the court said that no matter the method of allocation, a lack of the drugs has been reported from Nagpur – a city with a high prevalence of the infection.
Mucormycosis is a fungal infection that has been reported among hundreds of Covid-19 patients. It is caused by a fungus named mucor, which is found on wet surfaces. The symptoms of the infection include headache, fever, pain under the eyes, nasal or sinus congestion, and partial loss of vision, among others. It mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness and most commonly affects the sinuses or the lungs after inhaling fungal spores from the air, according to the United States’ Centers for Disease Control and Prevention.
On Tuesday, the Delhi High Court had asked the Centre to prioritise treatment of the younger population and frame a policy on the distribution of Liposomal Amphotericin B.
The Opposition has repeatedly questioned the Centre’s policy for mucormycosis cases as states battle a surge in the fungal infections amid the Covid-19 crisis.
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‘Black fungus’ or mucormycosis cases in India
On May 20, the Centre had asked the states and Union Territories to declare mucormycosis a notifiable disease under the Epidemic Diseases Act 1897.
On May 22, Union minister Sadananda Gowda said there are 8,848 cases of mucormycosis or “black fungus” in India. The minister added that 23,680 additional vials of Amphotericin-B, the drug used to treat the infection, have been allocated to the states.
One of the potential causes of the fungal infection is reportedly the use of steroids for Covid-19 treatment, which increases blood sugar levels.
On May 22, the Centre had urged health professionals to stop the irrational use of steroids for treating coronavirus patients and said it was contributing to the increase in “black fungus” cases.
Steroids reduce inflammation in the lungs for Covid-19 and the body’s immune system goes into overdrive to fight off the virus. However, they also may reduce immunity and push up blood sugar levels in both diabetic and non-diabetic Covid-19 patients, according to doctors quoted by the BBC. The drop in immunity might then exacerbate the “black fungus”.
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