Following the COVID-19 crisis, India is facing a ‘black fungus’ epidemic

AHMEDABAD, India – In the swollen and congested medical ward of the Civil Hospital, an ear, nose and throat specialist moved rapidly from bed to bed, flashing a flashlight in the patient’s mouth while examining the patient’s X-rays.

The specialist, Bela Prajapati, treats nearly 400 patients with mycomycosis, a rare and often dangerous fungal disease that has emerged from across India International spread of corona virus. With little preparation The second salutation of COVID-19 Released this spring, many hospitals in India took drastic measures to save lives, but it allowed another deadly disease to emerge.

“The epidemic has caused an epidemicPrajapati said.

At three weeks, the incidence of the disease – mistakenly named “black fungus” because it is found in dead tissue – rose to more than 30,000 compared to previously neglected levels. More than 2,100 deaths have been reported in the states News reports. The country’s health ministry in New Delhi, which has been monitoring cases across the country for distributing cheap and expensive antifungal drugs, has not released the official death toll.

Corona virus infection signifies deep divisions between rich and poor countries, and mycomycosis is its most recent manifestation in India. During the second wave that hit India in April, its health system Fragile and bad finance No beds, no oxygen and no other needs as infections and deaths increased.

Mucomycosis infection adds even more urgency to the difficult task of protecting India’s 1.4 billion people. Only a small area has been vaccinated against COVID-19, and they are vulnerable to the third wave and its possible consequences.

“As the number of COVID cases decreases, mycosis will return to a minimum,” said epidemiologist Dilip Mavalankar. “But if it doesn’t figure out why it’s happening, it could come back in the third wave.”

Many doctors in India think they know why. Bone and tissue-eating fungi can infect the gastrointestinal tract, lungs, skin and sinuses, where if left untreated it can often spread to the eye socket and brain. Treatment for the disease involves complex and often degenerative processes and expensive and undetectable drug, which contributes to a mortality rate of more than 50 percent.

Mucomycosis is not transmitted from one person to another. It sometimes develops from common spores that accumulate in homes and hospitals. Doctors believe that India’s overcrowded hospitals and lack of medical oxygen have led to the fungus.

Without enough oxygen for everyone, in many places, doctors prescribed steroids to patients, which is a standard treatment for medical groups struggling with COVID worldwide. These reduce inflammation in the lungs and help Kovit patients breathe easier.

Microbiologist and co-author Arunalok Chakrabarty said that many doctors prescribe steroids in doses that are longer than recommended by the World Health Organization. Study Investigates the causes of eruption of mycomycosis in India. These steroids may have compromised the immune systems of COVID-19 patients, making them more susceptible to fungal infections.

Steroids can raise blood sugar to dangerous levels, making diabetics more likely to suffer from mycomycosis. They can also increase the chances of developing frostbite, which can lead to malnourished tissues, which “attacks the fungus,” Prajapati explained.

Desperate doctors may not have the opportunity to ask patients if they have diabetes or other conditions before coming to steroid treatment.

“Doctors don’t have time to do routine patient tests,” Emperor said. “They were all focused on attending the trachea.”

According to the Ministry of Health, four out of every five patients with mucomycosis have COVID-19. More than half have diabetes.

Alok Kumar Chaudhry, a 30-year-old engineer, had surgical tape over his left eye and was attached to a nerve line at the Civil Hospital, one of the first patients with mycomycosis of COVID.

In April I was studying for the Indian Civil Service exam in New Delhi when the second wave hit. After a positive test for the corona virus and facing hospital beds, medication and lack of oxygen, he boarded a train to go to his elder brother’s house in rural Gujarat. There, 54 percent of their oxygen levels are dangerous.

After two weeks on oxygen and steroids at a local hospital, he recovered from COVID-19, but developed a severe headache on the left side of his brain. Doctors thought it was a temporary effect of steroids.

“Suddenly the vision in my left eye became empty,” said Soudri.

An MRI showed the presence of mycomycosis. Doctors said his eye had to be removed.

Went to Ahmedabad Civil Hospital for second opinion. Five specialists supervised a surgical procedure involving the removal of dead tissue from the sinus tube. To remove the remnants of the infection, he received the fungicide Ambotericin B for 15 days.

The emperor said that if Sadh had the eye, he would lose his life because the surgeons could not remove it without removing the thin layer behind the eye.

“I have lost sight in my left eye and my studies have been affected,” said Sadri. “I want to know for sure why it happened. If it was for the wrong treatment, someone would be responsible. If it was the wrath of God, what could I do?”

The study, co-authored with the Emperor, it Released this month He noted that overuse of steroids, contact with diabetes and unhealthy conditions contributed to the current situation by the Centers for Disease Control and Prevention in the United States.

Prior to the epidemic, there were about 50 cases of mycosis in India per year, compared to once every two years, on average, in the United States and Western Europe. Environmental conditions play a role as well as diabetes: more than twice as many people are affected by this disease in India as in the United States.

In general, in India, myocomycosis affects diabetics who are not known to be ill or have not taken insulin properly. However, in the current outbreak, many patients do not have a history of diabetes. Physicians and researchers report that the most common class is COVID-19 infection treated with steroids.

In May, the government in Ahmedabad, Gujarat declared mycosis as an epidemic. Other states have followed suit. For patients, the difference between life and death often depends on how quickly they undergo decomposition surgery, which removes the fungus and then begins a two-week treatment with amphotericin B.

First Prime Minister of Gujarat Narendra Modi, Fungal disease described He said a new “challenge” and “it is important to build systems to combat it.”

India produces small amounts of amphotericin B, which can be obtained free of cost from some public hospitals. However, suppliers are limited, so India imports this drug from the United States, where it costs $ 300 per bottle. Each patient needs 60 to 100 vials. Gilead Sciences, an American manufacturer, has donated about 200,000 bottles.

Because of the damage to the kidneys, doctors are turning to cheaper drugs, but they are more toxic.

“It was a very painful choice,” said Atul Patel, an epidemiologist at Sterling Private Hospital in Ahmedabad, who has treated dozens of patients with myocomycosis during the outbreak.

Patel, one of the authors of the study, said that steroids, which are often prescribed in India for common ailments like diarrhea or fever, are not needed by Kovit-19 patients due to mild infections.

One of Patel ‘s patients, Ambaben Heerabai Patel, 60, a matriarch from a farming family in rural Gujarat, pays about $ 700 a day for fungal treatment and other services in Sterling.

It’s expensive, but Ms. Patel’s diabetes is related – to her previous health problems related to diabetes. After a series of COVID-19 infections and mycosis, he did not want to take any chances.

Patel, who arrived at the hospital on May 17 with a severe headache and facial numbness, said he was healthy for the first time in more than a month from his private room at Sterling Hospital in early June.

About Dr. Patel, he said, “Like my God.”

Emily Schmal is a New Delhi-based South Asian correspondent. emilyschmall