19 black fungus deaths in 3 govt, civic hosps since Feb

Patients hesitate to approach after Covid even if they show symptoms, say doctors; hospitals complain of shortage of life-saving drugs

MUMBAI: Since the beginning of the second wave in February, a total of 19 recovered Covid patients have succumbed to the black fungus—mucormycosis – at three major government and civic-run hospitals in Mumbai. Doctors attribute the death to the delay in diagnosis and unavailability of life-saving antifungal medicine — Liposomal Amphotericin B – which delayed the timely treatment.

Mucormycosis is a serious, but rare fungal infection caused by a group of mould called mucormycetes. It causes blindness, organ dysfunction, loss of body tissue and even death if not treated in time, as per doctors.

“This infection has a 50% mortality rate. Since the second wave, we have treated over 45 patients suffering from mucormycosis. Of these, 15 have succumbed, which makes the mortality rate 33%,” said Dr Renuka Bradoo, head of department of ENT, Lokmanya Tilak General Hospital, which is also known as Sion Hospital.

Additionally, three deaths have been reported at government-run Sir JJ Hospital since February. At present, the hospital is treating 51 patients with mucormycosis. Another patient from King Edward Memorial (KEM) hospital in Parel died of the infection last week.

Almost 80% of the patients are not residents of Mumbai. BYL Nair Hospital is currently treating 11 patients, but none of them are Mumbai residents. After Covid-19 recovery, patients often hesitate to visit hospitals, even if they develop symptoms such as headache, stuffy nose and droopy eyes, according to doctors. “When it aggravates and they develop black patches on noses or eyes turn completely red, they rush to hospitals. Doctors then have to debride the dead tissues and patients lose their noses, eyes and palate,” said Dr Ramesh Bharmal, dean of Nair Hospital. “In severe cases, when the infection reaches the brain, patients die,” he added.

Due to the sudden rise in mucormycosis cases, hospitals are running out of the life-saving drug. “We are seeing a lot of patients. We have to monitor the patients for four-six weeks. The best medicine is Liposomal Amphotericin B injection, which is not available for weeks now. Similarly, the other Amphotericin B has also gone off the shelves. Now, we are mostly treating patients with another anti-fungal medicine— Posaconazole,” said Dr Bradoo.

Dr Hetal Marfatia, head of the department, ENT at KEM hospital, also confirmed the shortage of medicines. “There is a shortage of medicines. Our procurement department is working on it.”

The Brihanmumbai Municipal Corporation (BMC) has also taken note of the shortage and floated tenders last week to procure the medicines. FDA commissioner Parimal Singh said currently they had around 16,000 vials of Amphotericin B. “We are in talks with the Central government to procure more injections,” he said.

Dr Bradoo emphasised that the authorities need to expedite the process as these are lifesaving drugs. “Earlier, we used to get around 10 cases annually. But since the start of the second wave, we are getting three-four cases on a daily basis. These antifungal medicines have become as essential as oxygen to save the lives of patients,” she added.

The Retail and Dispensing Chemists Association has also requested the manufactures to increase the production to meet the sudden demand. “As we have been informed, individuals won’t be able to procure the injection directly from the chemists. They will have to approach their respective collectors’ offices. The admitted patients will get it through the hospitals,” said Prasad Danave, president of the association.