A day after the Union health ministry asked states and union territories to declare mucormycosis or black fungus a “notifiable disease” under the Epidemic Diseases Act 1897, the West Bengal health and family welfare department issued a general advisory in this regard yesterday. Besides Covid-19, mucormycosis has emerged as a big challenge for doctors.
On order to prevent the disease, the advisory has stressed on controlling diabetes, strict and proper use of masks and special emphasis to be given while visiting congested areas. It has asked people to wear shoes, long trousers, long sleeve shirts and gloves while handling soil (gardening), moss or manure.
“Environmental cleanliness to have no exposure to decaying organic matters like breads /fruits/vegetables/soil/ compost/excreta/etc,” the advisory reads. It has further alerted on the optimal steroid use, stating the right timing of initiation, right dose, and right duration. It has also stressed on the use of clean distilled water in humidifiers during oxygen therapy.
The advisory has asked monitoring blood glucose level postCovid-19 discharge in diabetics, regular examination to find any warning signs, and judicious use of steroids, antibiotics, and antifungal drugs. Among the symptoms to suspect (uncontrolled diabetes in Covid-19 patients or immunosuppressed individuals), sinusitis, nasal blockade or congestion, nasal discharge (blackish/bloody), local pain on the cheekbone, one sided facial pain, numbness or swelling, blackish discoloration over bridge of nose/palate, toothache, loosening of teeth, jaw involvement.
Blurred or double vision with pain, fever, skin lesion; thrombosis & necrosis (eschar), chest pain, pleural effusion, haemoptysis, and worsening of respiratory system have been mentioned as other symptoms. The advisory advises on strict diabetes and diabetic ketoacidosis control. To reduce steroids with the aim to discontinue them, and discontinue immunomodulating drugs. It has said that no antifungal prophylaxis is needed, while it has said antifungal therapy is needed for at least four-six weeks.
“Mucormycosis is a fungal infection that mainly affects people who are on medication for other health problems that reduces their ability to fight environmental pathogens. Sinuses or lungs of such individuals get affected after fungal spores are inhaled from the air. This can lead to serious disease with warning signs and symptoms as follows: pain and redness around eyes and/or nose, fever, headache, coughing, shortness of breath, bloody vomits, altered mental status,” the advisory reads.
It has said that radiodiagnosis expert, internal medicine specialist / intensivist, infectious disease expert, specialist ENT, specialist neurologist, ophthalmologist, dental surgeon, surgeon (maxillofacial/plastic) and endocrinologist could be approached.
Suspected black fungus case in Siliguri
A 50-year-old woman of Siliguri was admitted in the North Bengal Medical College and Hospital yesterday with suspected mucormycosis symptoms, sources said. It is learnt that she had recently recovered from Covid-19.
Her swab sample has been taken for examination for the fungas strain, the sources added. 540 new Covid cases in Darjeeling district On the other hand, Darjeeling district recorded 540 new cases of Covid-19 today, sources said.
While 220 cases were detected in the Siliguri Municipal Corporation (SMC), four cases were found in Darjeeling Municipality, 13 in Sukna, 17 in Kurseong Municipality, 19 in Mirik, 11 in Bijanbari, eight in Sukhia Pokhari, one in Takdah, 20 in Kharibari, 125 in Matigara, 89 in Naxalbari, and 13 cases in Phansidewa.
Separately, 111 cases were detected in areas in the SMC that fall under Jalpaiguri district, the sources said. Also today, 372 Covid patients recovered in wither home isolation or government Covid facilities today, sources said.
Nine Covid patients die
Nine persons, who had tested positive for Covid-19, died in Siliguri today, sources said. Seven persons died at the North Bengal Medical College and Hospital, while two persons, including an 80year-old veteran lawyer, died in two private nursing homes.