Centre asks state governments to tackle black fungus on a war footing

States have been asked to prepare and implement the infection prevention control programme in hospitals in accordance with the National Guidelines for Infection and Control in Healthcare Facilities

The Centre has advised states to review their preparedness for infection prevention and control, as well as hygiene and sanitation in hospitals. This is in light of the increasing number of black fungus or mucormycosis cases.

Union health secretary Rajesh Bhushan, in his letter to chief secretaries and administrators of all states, asked them to establish or activate the hospital infection control committee chaired by head of the institution or an administrator. Also, he asked them to designate an infection prevention and control nodal officer, preferably a microbiologist or a senior infection control nurse.

States have also been asked to prepare and implement the infection prevention control programme in hospitals in accordance with the National Guidelines for Infection and Control in Healthcare Facilities. The health ministry has also said that, irrespective of their individual routine, all hospital staff have to be trained in infection prevention and control in accordance with the hospital infection control manual.

Infection control has to be enhanced in ICUs as well using a bundle-approach to prevent device-associated infections such as ventilator-associated pneumonia, catheter-associated blood stream or urinary infections.

“Transmission-based precautions need heightened focus on droplet, airborne and contact precautions from the perspective of protecting healthcare workers and ensuring patient safety,” the health ministry said.

The government has also advised states to establish surveillance of healthcare-associated infections with focus on ventilator-associated pneumonia, catheter-associated blood stream, urinary tract infection, surgical site infections or gastro-intestinal outbreak.

The ICMR, too, has issued guidelines for screening, diagnosis and management of black fungus. There have been 197 cases of black fungus in Delhi so far, out of which some patients are from outside the National Capital. “Take steroids only on doctor's advice. Black fungus is occurring due to increase in blood sugar levels and decreased immunity by taking steroids,” Delhi health minister said.

Delhi-based Akash Healthcare has treated five such cases successfully so far but has raised the issue of drug shortage for treating black fungus. “Amphotericin B has lesser side effects but its production is controlled. This makes it less available in the market. With the surge of mucormycosis cases, they are rarer to find,” said Aashish Chaudhry, managing director (MD), Akash Healthcare.

The health ministry on Thursday had asked all states to make black fungus as a notifiable disease under the Epidemic Diseases Act 1897.

Treatment of the black fungus infection requires a multidisciplinary approach of eye surgeons, ENT specialists, general surgeons, neurosurgeons and use of amphotericin B as an antifungal drug.