With over 11,000 cases, black fungus or Mucormycosis has posed double trouble for India, who is already struggling with the catastrophic second wave of COVID-19. The country's Ministry of Chemicals and Fertilisers on Wednesday allocated over 29,250 additional vials of Amphotericin-B, a drug that is used in the treatment of Mucormycosis or black fungus to all the states.
The worst-affected states, like Maharashtra and Gujarat, have been given over 6,000 and 7,000 vials respectively. Both states currently lead in Mucormycosis infections, with 2,859 and 2,770 cases.
These allocations come after the demand for Amphotericin-B shot up nearly three-fold during April-May.
On Monday, the Delhi High Court said the gap between demand and supply of Amphotericin-B is "too wide to bridge" and drastic steps are required.
"We are not getting the Amphotericine-B medicine from the last 12 days. Hospitals are sourcing the medicine from all distributors. Ideally, the medicine has to be given before and after surgery and at least a minimum of 12 injections has to given to a patient continuously. We have to use alternative antifungal medicine like Posaconazole and Isavuconazole", Dr Divya Prabhat, ENT surgeon at the Bhatia Hospital told Sputnik.
The doctor feared cases will continue to grow because there is a lag period between the onset of the disease until lab reports confirm its presence, which could take at least a week. "So taking this into consideration, Maharashtra would require more than 60,000 vials of Amphotericin-B medicine", Dr Prabhat added.
However, the increasing demand points out that only doubling up supplies will not help as domestic production is much lower than what is required. The Delhi High Court had also asked the government to immediately import the antifungal drug Amphotericin-B "from wherever it is available in the world" and directed it to put on record the steps being taken to import the medicine.
As per reports, one of the reasons for this crisis is the shortage of lipids, one of the raw materials used to manufacture Liposomal Amphotericin-B (LaMB). LaMB, an over 20-year-old drug, is otherwise rarely used.
"Amphotericin-B is being actively prescribed by doctors to patients suffering from this post-COVID complication. Since this medicine was rarely used earlier, the sudden increase in demand has led to a panic situation. Doctors say there are some alternatives. For mild cases of Mucormycosis or patients who have completed one course of Amphotericin-B, Posaconazole tablets, or Noxafil (posaconazole) syrups are being prescribed. The companies are fast gearing up to meet the increase in demand", Dr Gurpreet Sandhu, president of the Council for Healthcare and Pharma told Sputnik.
Mucormycosis is a rare fungal infection caused by exposure to mucor mold which is commonly found in soil, plants, manure, and decaying fruits and vegetables. It affects the sinuses, the brain, and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS. As per doctors, it has an overall mortality rate of 50%, and may be triggered by the use of steroids which is a life-saving treatment for severe and critically ill COVID-19 patients. The use of industrial oxygen is also being cited as a possible cause of this spike in fungal infection.