New Delhi: Total 45,432 cases mucositis As reported by states and union territories till July 15, of which 21,085 affected people are undergoing treatment and 4,252 have died, the Rajya Sabha was informed on Tuesday.
The majority of patients with mucormycosis (84.4 percent) reported a history of COVID-19, Union Health Minister Mansukh Mandaviya said in a written reply.
The most common presentations of mucormycosis include: rhinoceros (77.6 percent), cutaneous (4.3 percent) and pulmonary (3.0 percent).
In the wake of the second wave of COVID-19, the number of cases of mucormycosis increased and the Ministry of Health, after a thorough analysis and consultation, took several steps to address the problem.
Mucormycosis and other fungal infections are usually viewed as an opportunistic infection. They are found in people with low underlying immunity either due to diabetes, cancer especially hematological malignancies etc. or as a side effect of prolonged/irrational use of certain drugs like steroids, immunosuppressive drugs for the management of other disorders including COVID-19 are found as. The minister explained.
Mandaviya said that although it is not a new disease, its actual incidence during the start of the second wave was unknown as it was not a notifiable disease.
The health ministry in May urged states to declare mucormycosis as a notifiable disease under the Epidemic Diseases Act to obtain an objective assessment of the disease.
Taking note of the association between high blood glucose levels (whether in patients with pre-existing diabetes, or in patients with hyperglycemia due to steroid therapy), an update on the diagnosis and management of diabetes in a COVID-19 patient management facility “Clinical Guidance” was issued. Ministry June 1.
After expert consultation in national task force On COVID-19, a detailed advisory on the treatment and management of covid-19-associated mucormycosis (CAM) was formalized and circulated on 7 June.
Amphotericin-B has been prescribed and is available in two formulations, liposomal amphotericin B and amphotericin B deoxycholate, which are similar in efficacy.
However, the latter needs to be used with more caution with regard to its effects on kidney function tests and electrolyte imbalances, the minister explained.
The second drug of choice is posaconazole which may be used in cases of impaired renal function, drug reaction to amphotericin B, electrolyte imbalance or non-availability of amphotericin B.
A checklist for the management of mucormycosis and other fungal infections was also circulated to all states and union territories on June 11.
The Clinical Management Guidelines for Management of COVID-19 Cases by the Ministry advocates rational use of steroids for the management of moderate to severe cases of COVID-19 under medical supervision.
For reporting of cases and deaths due to mucormycosis, the ministry has requested the states and union territories to submit the details on the COVID-19 India portal.
The states were asked to update the data on the portal, which has helped the ministry to analyze and keep track of the emerging nature of the problem.
Responding to a question whether the government has taken cognizance of shortfall in the supply of amphotericin-B injections used to treat mucormycosis, Mandaviya said the details of production, stock, supply and purchase orders from the manufacturers since early May. and their cooperation was sought in bridging the gap between supply and demand.
He said that the first and second line drugs used for the management of cases of mucormycosis are currently adequately available in the Indian markets.
He said in response that the Department of Pharmaceuticals (DOP), Central Drugs Standard Control Organization (CDSCO) and National Pharmaceutical Pricing Authority (NPPA) are jointly monitoring the production and availability of critical COVID drugs including amphotericin-B injection.
The Center has taken several measures to improve the availability of amphotericin B (liposomal) through a multi-pronged approach of increasing production, and imports and ensuring equitable distribution to the States and UTs. It is also working with manufacturers to resolve issues related to raw materials.
The Department of Pharmaceuticals in the US and the Embassy of India, M/s Gilead Inc. Consistently working with Mylan Labs to increase imports from USA and ensure speedy deliveries.
The allocation is being made to the States and Union Territories in proportion to their reported case load for equitable distribution.
Monitoring the supply system National Pharmaceutical Pricing Authority (NPPA) to ensure speedy availability of the drug, the reply said.
NPPA has put in place a robust responsive system to ensure timely supply of allotted quantities and maintain constant liaison with the States and UTs and suppliers.
In a separate reply, he said that the treatment of mucormycosis and other fungal infections is made available free of cost in all central government hospitals and autonomous institutions under the ministry.
Ayushman Bharat PM-JAY provides free health cover up to Rs. 5 lakh per year per family. The scheme was launched with 10.74 crore beneficiary families. However, 33 States/UTs have increased the beneficiary base to 13.44 families.
Ayushman Bharat PM-JAY beneficiaries can avail free treatment after complications related to covid including mucormycosis, downy mildew etc under the scheme.
States are also being supported in the matter of allocation and supply of amphotericin B.
Amphotericin B is being provided at an affordable price under Pradhan Mantri Bhartiya Janaushadhi Pariyojna (PMBJP)
The majority of patients with mucormycosis (84.4 percent) reported a history of COVID-19, Union Health Minister Mansukh Mandaviya said in a written reply.
The most common presentations of mucormycosis include: rhinoceros (77.6 percent), cutaneous (4.3 percent) and pulmonary (3.0 percent).
In the wake of the second wave of COVID-19, the number of cases of mucormycosis increased and the Ministry of Health, after a thorough analysis and consultation, took several steps to address the problem.
Mucormycosis and other fungal infections are usually viewed as an opportunistic infection. They are found in people with low underlying immunity either due to diabetes, cancer especially hematological malignancies etc. or as a side effect of prolonged/irrational use of certain drugs like steroids, immunosuppressive drugs for the management of other disorders including COVID-19 are found as. The minister explained.
Mandaviya said that although it is not a new disease, its actual incidence during the start of the second wave was unknown as it was not a notifiable disease.
The health ministry in May urged states to declare mucormycosis as a notifiable disease under the Epidemic Diseases Act to obtain an objective assessment of the disease.
Taking note of the association between high blood glucose levels (whether in patients with pre-existing diabetes, or in patients with hyperglycemia due to steroid therapy), an update on the diagnosis and management of diabetes in a COVID-19 patient management facility “Clinical Guidance” was issued. Ministry June 1.
After expert consultation in national task force On COVID-19, a detailed advisory on the treatment and management of covid-19-associated mucormycosis (CAM) was formalized and circulated on 7 June.
Amphotericin-B has been prescribed and is available in two formulations, liposomal amphotericin B and amphotericin B deoxycholate, which are similar in efficacy.
However, the latter needs to be used with more caution with regard to its effects on kidney function tests and electrolyte imbalances, the minister explained.
The second drug of choice is posaconazole which may be used in cases of impaired renal function, drug reaction to amphotericin B, electrolyte imbalance or non-availability of amphotericin B.
A checklist for the management of mucormycosis and other fungal infections was also circulated to all states and union territories on June 11.
The Clinical Management Guidelines for Management of COVID-19 Cases by the Ministry advocates rational use of steroids for the management of moderate to severe cases of COVID-19 under medical supervision.
For reporting of cases and deaths due to mucormycosis, the ministry has requested the states and union territories to submit the details on the COVID-19 India portal.
The states were asked to update the data on the portal, which has helped the ministry to analyze and keep track of the emerging nature of the problem.
Responding to a question whether the government has taken cognizance of shortfall in the supply of amphotericin-B injections used to treat mucormycosis, Mandaviya said the details of production, stock, supply and purchase orders from the manufacturers since early May. and their cooperation was sought in bridging the gap between supply and demand.
He said that the first and second line drugs used for the management of cases of mucormycosis are currently adequately available in the Indian markets.
He said in response that the Department of Pharmaceuticals (DOP), Central Drugs Standard Control Organization (CDSCO) and National Pharmaceutical Pricing Authority (NPPA) are jointly monitoring the production and availability of critical COVID drugs including amphotericin-B injection.
The Center has taken several measures to improve the availability of amphotericin B (liposomal) through a multi-pronged approach of increasing production, and imports and ensuring equitable distribution to the States and UTs. It is also working with manufacturers to resolve issues related to raw materials.
The Department of Pharmaceuticals in the US and the Embassy of India, M/s Gilead Inc. Consistently working with Mylan Labs to increase imports from USA and ensure speedy deliveries.
The allocation is being made to the States and Union Territories in proportion to their reported case load for equitable distribution.
Monitoring the supply system National Pharmaceutical Pricing Authority (NPPA) to ensure speedy availability of the drug, the reply said.
NPPA has put in place a robust responsive system to ensure timely supply of allotted quantities and maintain constant liaison with the States and UTs and suppliers.
In a separate reply, he said that the treatment of mucormycosis and other fungal infections is made available free of cost in all central government hospitals and autonomous institutions under the ministry.
Ayushman Bharat PM-JAY provides free health cover up to Rs. 5 lakh per year per family. The scheme was launched with 10.74 crore beneficiary families. However, 33 States/UTs have increased the beneficiary base to 13.44 families.
Ayushman Bharat PM-JAY beneficiaries can avail free treatment after complications related to covid including mucormycosis, downy mildew etc under the scheme.
States are also being supported in the matter of allocation and supply of amphotericin B.
Amphotericin B is being provided at an affordable price under Pradhan Mantri Bhartiya Janaushadhi Pariyojna (PMBJP)
.