rise in Covid cases, doctors predict black fungus will become more common worldwide.

India’s Health Ministry. By July, more than 4,300 people had died from the fungal infection.
Srinivas’s sister Shyamala V. sits by his bed and considers what life will be like for her brother’s wife and two young sons, ages 2 and four months, if he becomes one of them.
“I am very scared for him; he has two small kids. Who will look after them?” she said.
Srinivas S. went to four hospitals before they diagnosed his black fungus infection.
Srinivas S. went to four hospitals before they diagnosed his black fungus infection.
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of fungi, that people are exposed to every day, but when their immune systems have been battered by Covid they become more vulnerable to infection. Unless treated
Cases have surged in India, and a small number of cases have been detected elsewhere — in Nepal, Afghanistan, Egypt and Oman, according to their respective health ministries.
India’s black fungus cases numbers are far higher now than after the country’s first coronavirus wave last September. That may be due to the rapid spread of the Delta or B.1.617.2 variant of the virus.
Diabetes causes elevated blood sugar levels — perfect conditions for a fungus that feeds on sugar. In India, at least 77 million people had diabetes as of 2019, second only to China which had 116 million (the United States had 31 million) according to the International Diabetes Federation — which partly explains why Indian black fungus cases are comparatively high.
The World Health Organization says the prevalence of diabetes is rising more rapidly in low- and middle-income countries than high-income countries. Coupled with a
Surgeons examine an X-ray for signs of infection in Srinivas' brain.
Surgeons examine an X-ray for signs of infection in Srinivas’ brain.
Excruciating pain
Srinivas, who only uses one name, thought he was over the worst of Covid-19, but his left eye soon started swelling so much he could barely open it. The pain was excruciating.
He had never heard of black fungus but became concerned when his eye and nose started bleeding in May. “A lot of blood was coming out, so I thought, what is happening?” Srinivas told CNN from his hospital bed before his third operation to remove infected tissue.
Srinivas said he went to four hospitals before doctors diagnosed him with black fungus and referred him to a fifth hospital where he finally received treatment.
Before the pandemic, India had about 3,000 to 4,000 cases of mucormycosis each year, according to figures provided to the Indian Parliament by Health Minister Mansukh Mandaviya.
Back then, the illness wasn’t notifiable, meaning states weren’t obliged to report cases to the central government. That changed in May as case numbers grew. By the end of June, more than 40,845 cases had been reported nationwide.
Two weeks later, that number had risen by around 9% to 45,374. Of those patients, around half are still receiving treatment, the Health Ministry said on Tuesday.
A shortage of drugs
There is no quick fix for mucormycosis. Patients undergo surgery to remove infected tissue in a procedure known as debridement. They are then treated with the antifungal medication liposomal amphotericin B to keep the infection from resurging.
As case numbers rose in May, several states reported shortages of the drug and India’s Ministry of Chemicals and Fertilizers stepped in to regulate supplies. An extra five companies were approved to produce the drug in India, and new import orders were placed.
Surgeons remove mucormycosis from a patient who recovered from Covid-19 at Swaroop Rani hospital in Allahabad, India on June 5.
Surgeons remove mucormycosis from a patient who recovered from Covid-19 at Swaroop Rani hospital in Allahabad, India on June 5.
In early June, doctors at St John’s Hospital said they were still being forced to ration doses due to erratic supplies. “It becomes a big challenge because do I under-dose 11 patients by giving one each when I’m supposed to give three to every patient? Do I select patients who get this amphotericin B? It’s been extremely tough,” said Dr. Sanjiv Lewin, the hospital’s chief of medical services.
Later that month, Lewin said supplies of the drug improved slightly but remained unpredictable. At that time, Srinivas’ sister said he had not received his dose of liposomal amphotericin B for three days.
Even private hospitals have to ask for the drug from government hospitals. It’s simply not available anywhere

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