India recorded 4252 mucormycosis deaths and over 45,432 cases, the Ministry of Health and Family Welfare shared in the Rajya Sabha. About 84.5 per cent of these cases were found in people who had already developed COVID-19.
In a written reply, the Health ministry shared that they had asked states to identify Mucormycosis as a notifiable disease only in May 2021 under the Epidemic Disease Act, 1897 to get an objective assessment of the infection in the community.
But, it is unclear if the cases reported by the Health Ministry are from May or also include cases that were earlier reported. The first outbreak of mucormycosis was reported by Sir Ganga Ram Hospital way back in December 2020. The cases exponentially increased during the second wave which swept India in the months of April and May.
According to the data available with the World Health Organisation, only India has reported a COVID-19 associated Mucormycosis surge across the world.
Mucormycosis, an opportunistic infection, targets those with a lower immunity and living in unhygienic conditions. In case of COVID-19, the patients are already fighting the disease making the body susceptible to further infections. Along with this, the irrational use of steroids led to a rise in blood sugar levels. Experts also believe that the unhygienic oxygen pipes could be a source for fungal infections.
The state-wise classification showed that around 1632 patients chose to take leave against medical advice when hospitalised. The remaining patients showed signs of recovery. The government, however, has not shared details of people who suffered vision loss due to mucormycosis.
Maharashtra with over nine thousand cases and Gujarat with over six thousand cases are the states leading in mucormycosis cases.
Around 77.6 per cent of the cases were rhinocerebral which means that they affected the sinus and the brain, only 4.3 per cent were diagnosed through skin lesions- through the cutaneous. About 3 per cent of the cases were of affected lungs and were classified under pulmonary mucormycosis.
The ministry added that were aware of the relationship between elevated blood sugar levels among patients being diagnosed with mucormycosis, they released the updated "Clinical Guidance on Diagnosis and Management of Diabetes at COVID-19 Patient Management facility" in June 2021.
After constant deliberations with the National Task Force on COVID-19, a detailed advisory on treatment and management of COVID-19 associated Mucormycosis (CAM) was released on June 7, 2021. They also released a checklist for identifying signs and symptoms of this fungal infection.
Even before the reports of mucormycosis, several doctors spoke about judiciously using steroids for treating COVID-19. The Health Ministry, after increasing reports started asking doctors to not over-prescribe steroids to patients. They even released the "Advisory for rational use of Steroids and Tocilizumab in the treatment of Covid -19 patient" informing about the calculated use of the drugs.
The surge of mucormycosis cases also brought about an increase in demand for the drug Amphotericin-B which was in short supply across the country. The Department of Pharmaceuticals under the Ministry of Chemicals and Ferilizers headed by the current Health Minister Mansukh Mandaviya amped up the production for the drug across the country.
To ensure that Liposomal Amphotericin-B is available to those in need, the Drugs Controller General of India gave manufacturing licenses to eleven firms and the Ministry of External Affairs also managed to import close to 11,800 doses of the medicine.
Currently, according to the ministry, 21,085 people are recovering and being treated for this fungal infection.