Rajat Sharma

The battle against Black Fungus, White Fungus and Coronavirus

akb fullThe Centre on Thursday directed all state and UT governments to declare Mucormycosis, known as ‘Black Fungus’, a notifiable disease under the Epidemic Diseases Act, after reports came about 126 deaths due to this deadly disease till now across India. Nearly 5,500 cases have been officially reported till now from different states.

The key drug, Liposomal amphotericin B, used for treatment of Black Fungus, has now become scarce in Delhi and nine other states and the Centre has asked pharma companies to ramp up production on a war scale. In Delhi, there are more than 200 patients suffering from Black Fungus undergoing treatment in different hospitals. Most of them are aged above 50 years. Maharashtra is the worst-hit state with 90 deaths so far, followed by 14 deaths in Haryana. Meanwhile, reports came in of White Fungus surfacing in Patna, the capital of Bihar.

With the AIIMS issuing guidelines about detection and treatment of Black Fungus disease, I spoke to Dr Nikhil Tandon, Head of department of endocrinology, metabolism and diabetes, in my prime time show ‘Aaj Ki Baat’ on Thursday night, about various issues relating to this deadly epidemic. He is considered an expert on fungal infection.

During the interview, Dr Tandon made some points clearly: One, neither black fungus nor white fungus are new diseases, there are fungii in our environment, but earlier there were very, very few such fungus-related cases, but due to widespread use of strong steroids during Covid-19 treatment, the black fungus surfaced and targeted mostly diabetics, who have lower immunity. This black fungus attacks the small blood vessels and capillaries.

Two, timely detection of the disease can save a patient. Dr Tandon advised people not to self-medicate if they have problems like cough, cold and fever. Secondly, he asked people to be on the look out for symptoms like red eyes, swollen face, blurred images and spots on face. Do not be scared, go to a specialist and get yourself checked through different tests. This disease cannot be treated at home. It can be treated only in hospitals. Dr Tandon also explained what precautions people should take after recovering from Covid-19. Both the Centre and state governments are now alert about Black Fungus disease, and efforts are being made to provide adequate stocks of the key drug to all states.

White Fungus disease has been detected in Patna Medical College hospital, where nearly 50 Black Fungus patients are undergoing treatment. On Thursday, four new cases of White Fungus were detected. Doctors in the Patna hospital became worried when they noticed this deadly white fungus disease, which attacks the lungs and the chest cavity first, and then spreads to other organs in the body.

Our Patna reporter Nitish Chandra reported that in all the white fungus patients, the initial symptoms were cough followed by fever. When the oxygen saturation level started dipping, HRCT scan was carried out, which showed patches on lungs of patients. The symptoms were similar to those of Covid-19 patients. The surprising part was that all Rapid Antigen and RT-PCR tests conducted on these patients showed negative, but the patches on lungs gave vital clues to doctors.

One of the patients was a doctor himself, who insisted on getting his sputum tests done through culture, and the white fungus was detected. He was given anti-fungal drugs, and he recovered within three days. Our reporter spoke to the doctor Dr Basant Kumar, who said, he had a clear inkling that he has caught a fungal infection. When the Covid-19 test showed negative, he insisted on fungal infection test, and the fungus was caught in time.

White fungus is basically one, which is also known as Candidosis, that grows in moist skin parts of a human body. It basically surfaces due to weakened immune system, but can also be a side-effect of chemotherapy or antibiotic treatment. Fungi are generally found in water, air and surface. When kids wear diapers, they get skin rashes, while some people get ulcers inside their mouth. These are due to presence of fungus. Such fungi are treated with normal medicines, but if the fungus reaches the lungs, it becomes deadly. Both black fungus and white fungus attack those who have a weakened immune system, or those who are suffering from diabetes, AIDS or cancer. Doctors say, use of ordinary tap water in place of distilled water by people using oxygen cylinders in home, can also cause fungus infection in the lungs through nose and throat while inhaling oxygen.

The Centre has said that a multi-disciplinary approach is required for treatment of all black fungus and white fungus patients. Eye surgeons, ENT specialists, general surgeon and neuro surgeons should be part of this team. Health Ministry and Indian Council of Medical Research has formulated guidelines to be followed by all government hospitals, medical colleges and private hospitals for screening, diagnosis and management of all black fungus and white fungus cases. New cases are being reported daily from Delhi, Gurugram, Mumbai, Ahmedabad, Lucknow, and other cities of Maharashtra, Haryana and Bihar.

Delhi government has started preparing separate black fungus wards in LNJP hospital, GTB Hospital and Rajiv Gandhi Hospital. More than 400 black fungus patients are presently admitted in Ahmedabad Civil Hospital. Doctors and patients in almost all states are facing problem of availability of Liposomal injections.

With fungal infections spreading in states, the Centre on Thursday issued an alert about Coronavirus transmission. The office of the Principal Scientific Adviser to the Government of India issued an advisory titled “Stop the Transmission, Crush the Pandemic”. It cautioned people about aerosols carrying the deadly virus can travel in air up to a distance of 10 metres.

The advisory said: “Always Remember: People who show no symptoms can also spread the virus”. Proper ventilation can prevent the spread of the virus. Running air conditioners while keeping windows and doors shut, traps infected air inside the room, and increases risk of transmission from an infected carrier to others.” The advisory also recommended use of gable fan systems and roof ventilators in offices, auditoriums, shopping malls and other closed public spaces. “Frequent cleaning and replacement of filters is highly recommended.”

On aerosol and droplet transmission, the advisory said, saliva and nasal discharges in the form of droplets and aerosols by an infected person in the primary mode of virus transmissions. “Droplets emitted by an infected person land on various surfaces (where they can survive for a long time). As such, frequent cleaning of high contact points such as door handles, light switches, tablets, chairs and the floor with disinfectants like bleach and phenyl is recommended.”

The advisory said, community level testing and isolation will have to be ramped up in semi-urban and rural areas. Rapid antigen tests are a must for outsiders entering a locality, and wearing of N95 mask by health workers is essential. The Centre has a target of achieving 45 lakh Covid tests daily. Orders have been issued to procure rapid antigen kits. This will help in early detection and treatment of people infected with Covid-19.

It is a fact that thousands of people faced hardships and ordeals till last week due to the deadly second wave of the pandemic. There were severe shortages of oxygen supply and oxygen cylinders during those one and half months. They had to run from pillar to post in search of hospital beds and ICU ventilators. They had to wait in long queues with the bodies of their dear ones for cremation outside crematoriums. The situation has now turned for the better. There is no shortage of hospital beds. In most of the hospitals, beds are now available. Oxygen is now available in plenty, thanks to the wartime-like efforts made by Indian Railways, Indian Air Force and Navy. Army and paramilitary forces set up Covid hospitals to treat the needy.

Now that the situation has somewhat eased, let us vow never to drop our guard and be eternally vigilant against this deadly virus. Get yourself tested at the first hint of any Covid symptom, and isolate yourself immediately. Please do not self-medicate. It enhances the risks by several times. Consult a doctor. Do not take your mask lightly. Better wear a double mask which should fully cover your nose and mouth. The nation can survive only if all of us survive. The next important part is: vaccination. Every Indian needs to be vaccinated. The stocks of vaccines may be low presently, but the Centre has promised to bring in more stocks by next month. The next three months will witness a flurry of vaccination doses. Our war against Corona shall continue till the time 70 percent of Indians are not vaccinated.

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