Mucormycosis cases drop 56% in Mumbai since June 27
The number of active cases of mucormycosis, also known as black fungus, in Mumbai has dropped to 169 as of July 21, from 384 on June 27, according to the Brihanmumbai Municipal Corporation (BMC) data.
Mucormycosis is a serious, but rare fungal infection caused by a group of moulds called mucormycetes. According to doctors, it causes blindness, organ dysfunction, loss of body tissue and can be fatal if not treated on time.
So far, 825 Covid-19 recovered patients have been admitted to private, civic and government-run hospitals for mucormycosis in the city. Almost 70% of patients are not Mumbai residents. The civic body has overall spent around ₹18 crore on antifungal medicines for the treatment.
At the biggest civic-run hospital, King Edward Memorial (KEM) Hospital, Parel, so far, a total of 139 mucormycosis patients have been admitted, of which 63 are still undergoing treatment. Data shows
22 mucormycosis patients are being treated at BYL Nair hospital, Mumbai Central (total 86 cases so far); 24 at Lokmanya Tilak General (Sion Hospital) (total 78 cases so far); 13 at JJ, Byculla (145 total cases so far); 11 are under treatment at Dr RN Cooper hospital (42 total cases so far).
Health officers said the flattening of the pandemic curve has resulted in a drop in the number of patients. “Admission of patients with mucormycosis has declined drastically in the last one month as the daily count of Covid-19 patients has dropped. Most patients who are getting admitted now are referred patients from other hospitals,” said Dr Suresh Kakani, additional municipal commissioner, BMC.
Doctors have observed that some patients who have undergone surgeries for removal of the dead tissues with the infection are returning to hospitals with the residual mucus. “On an average, each patient has to undergo at least two-three surgeries, which includes aggressive surgical debridement. In severe cases, patients have to undergo five-six surgeries too,” said Dr Hemant Deshmukh, dean of KEM hospital, which has a special ward to treat mucormycosis patients.
Medical history shows that mucormycosis has a mortality rate of around 50%. However, in Mumbai, the fatality rate stands at 20%. Doctors have attributed this to timely intervention with the rise in awareness among people.
Over ₹18 crore spent on anti-fungal medicines
“Between May 25 and July 21, a total of 31,248 vials of Liposomal Amphotericin B have been procured for treatment of patients with mucormycosis,” said Dr Deshmukh. An analysis of the price shows that over ₹18 crore have been sent for procurement of the antifungal medicines.
There are two types of drugs—Liposomal Amphotericin B and plain Amphotericin B. The first one is considered more effective, but the cost is much higher than the later. One vial of Liposomal Amphotericin B costs between ₹5,900 and ₹6,200.
As per treatment protocol, when the black fungus infects the nose, sinus or palate, doctors give 5mg per kilogram (kg) of body weight. For instance, if a person is 60kg, he would require 300mg of the dose. Each vial consists of 50mg of the drugs. So, a patient needs 6 vials which costs ₹36,000 daily. But when the infection reaches the brain, doctors have to give 8-10mg per kg of the body weight. This doubles the daily medical expenditures.
Dr Deshmukh said, “Many patients who get admitted at private hospitals with mucormycosis are referred to KEM hospital when they can’t afford the expensive treatment. At present, most of the admitted patients are such referral patients.”