Following the first death of a Covid-19 patient from the lethal fungal infection called Mucormycosis, popularly known as Black Fungus, the 15-member expert committee of doctors constituted by the Uttarakhand government has provided some recommendations comprising preventions and treatment of the infection amid the ongoing pandemic, HT has learnt.
Director of AIIMS Rishikesh, Dr Ravikant while confirming the development, said that, “During the examination it was found that all the infected people were on immunosuppressants for Covid-19 treatment which caused this fungal infection in them.”
“The virus had affected their head and face. Out of the 14, 10 have undergone surgery while four will soon be operated upon. We have also formed a team of 15 doctors led by ear, nose and throat surgeon Dr Amit Tyagi which will monitor the disease, issue guidelines related to it from time to time and treat the patients while taking precautions,” he said.
The first death from Black Fungus in the state was reported at All India Institute of Medical Science (AIIMS) Rishikesh where a 36-year-old man died from it on Friday while the report came out on Sunday. Following the death, the doctors treating Covid-19 at the health institute examined other patients also during which 14 others were also found affected from it.
Following the development, the expert committee of doctors, constituted by the state government on Covid-19 management on Monday, provided recommendations to it on handling the Black Fungus disease among Covid-19 patients.
The committee – led by vice chancellor of Hemwati Nandan Bahuguna of Uttarakhand Medical Education University, Srinagar, Dr Hem Chandra and principal of Government Doon Medical College Dr Ashutosh Sayana – in recommendations provided a series of measures under precautions and treatment.
Explaining the risk factors for the fungal infection, the committee in its report stated that, “Those with high and uncontrollable diabetes, Covid patients receiving high doses of steroids for longer duration as part of Covid-19 treatment, patients who received immunodulatory drug Tocilizumab, patients on long term oxygen therapy and on ventilators and those with netropeia are on high risk of contracting the infection.”
On the various symptoms of the fungal infection in Covid-19 patients, it informed that the symptoms mainly include, “facial pain, unilateral facial swelling, nasal congestion, foul smelling, pain and redness around nose, foul smell from mouth, vision loss, eye swelling, headache, coughing and shortness of breath.”
Citing high mortality rate of about 70-80% in Black Fungus cases, the experts cautioned the government that such cases may be associated with ‘injudicious” use of steroids without any supervision of doctors.
Providing prevention measures at public level, it suggested wearing of masks specially at dusty construction sites.
“Maintain personal hygiene including thorough scrub bath, proper control of blood sugar, popular saline gargles, avoid water damaged areas and foods that have spoiled, clean refrigerators and pantry regularly and dispose off spoiling foods,” stated the experts’ report.
Regarding prevention measures for doctors at health facilities or hospitals, the doctors cautioned them against missing warning symptoms.
“The doctors treating Covid-19 patients should monitor blood glucose level post Covid-19 discharge and also in diabetics. Use steroids judiciously with correct timing, correct dose and duration,” it said while suggesting them to use “clean and sterilised water for humidifier during oxygen therapy. Frequent changes of humidifier solution should be done.”
It also asked the doctors to “avoid using Voriconazole as antifungal prophylaxis with judicious use of antibiotics.”