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Treatment Protocol for Black Fungus Issued, Be Vigilant on Signs and Symptoms, Advices Health Deptt

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mucormycosis in Himachal Pradesh

Shimla-Health and Family Welfare Department, Himachal Pradesh, on Monday informed that the State Covid Clinical Committee has taken out a detailed treatment protocol for Mucormycosis/ Black Fungus. The department has urged people to be vigilant on all the signs and symptoms of black fungus so that a timely medical aid can be sorted for. So far, Himachal has reported at least three cases of Mucormycosis. 

Mucormycosis is a fungal disease which generally affects the nose, eyes and cerebral area in a human body. The immunosuppressive treatments such as steroids being used in Covid-19 patients result in decrease in immunity. The chronic respiratory disease, intubation, mechanical ventilation and coexistence of other infections during COVID-19 also increase chances of mucormycosis, the department informed.

The department said that uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICUs stay, comorbidities like malignancy, post transplant are the major risk factors for this fungal disease.

Also Read: Himachal Pradesh Reports First Case of Black Fungus, Centre Writes to States to Declare It An Epidemic

Major Symptoms of Mucormycosis

The major symptoms that a person can be vigilant for this infection are headache, nasal obstruction which is persistent and not responding to medicines, nasal crusting and discharge, pain or loss of sensation over face, discolouration of skin, loosening of teeth, ulceration of palate or bridge of nose, black necrotic eschar in the nasal cavity and sinusitis, it informed.

In addition, the intra oral symptoms include intra oral pus discharge, ulceration of mucosa, loosening of teeth and unhealed tooth socket, mobility of maxilla. This fungal disease also affects eyes which can result in swelling and redness of eyes, double vision, loss of vision, pain in the eye, drooping eyelid.

How Mucormycosis Is Diagnosed 

Laboratory investigations that are done to confirm the disease are blood investigations, nasal endoscopic examination, X-ray, CT scan, biopsy, nasal crust sampling, bronco alveolar lavage etc, the department said.

Treatment of Mucormycosis

After recovering from COVID-19, one should closely monitor and should not miss any warning signs and symptoms mentioned above, as the fungal infection is found to emerge even weeks or months after recovery. One should make judicial use of steroids as per doctor’s advice to avoid risk of infection. Early detection of the disease can ease the treatment of the fungal infection.

“The medical management of mucormycosis is known and the disease is completely curable if detected early. This disease can be treated by injectable Antifungal amphotericin B and other medicines. The treatment also includes surgical debridement of the involved tissue,” the Health and Welfare department clarified.

The disease is preventable and controlling hyperglycaemia, monitoring blood glucose level in post Covid phase, using steroid judiciously, using mask, wearing shoes, long trousers, long sleeves, gloves while handling soil, moss or manure can ensure prevention of this disease, it added.

The Health Dept. also emphasised the patients who are on oxygen therapy or are using humidifier to ensure to use clean sterile and boiled tap water for humidifiers. Mineral water should not be used and the water should be changed in the humidifier on daily basis, it said.

A regular follow-up should be ensured in the initial three months, the Health and Family Welfare department informed.

Mucormycosis Not Contagious, 

The Ministry of Health and Family Welfare on Monday said that the Fungal infection observed in COVID-19 patients is mostly Mucormycosis. It further said that the infection is not contagious. 

“Mucormycosis is one of the general fungal infections being seen in recovering or recovered COVID-19 patients. The number of cases being reported is increasing, but it is not a communicable disease, meaning it does not spread from one person to another, like COVID-19 does,”Dr Randeep Guleria, Director, AIIMS, New Delhi, at a media briefing 

Dr Guleria says it is better not to use the term black fungus while talking of mucormycosis, as it leads to a lot of avoidable confusion. “Black fungus is another family; this term got associated with mucormycosis due to the presence of black dots among the culture of white fungal colonies. In general, there are various types of fungal infections such as candida, aspergillosis, cryptococcus, histoplasmosis and coccidioidomycosis. Mucormycosis, candida and aspergillosis are the ones observed more in those with low immunity.”

There is no definite link between oxygen therapy and catching the infection, he said. 

“90% – 95% of mucormycosis patients are either diabetic and/or taking steroids,” Dr Guleria informed.

Who is at Higher Risk of Developing Mucormycosis Infection:

  1. Uncontrolled diabetes
  2. Weakening of immune system due to use of steroids
  3. Prolonged ICU/hospital stay
  4. Co-morbidities / post organ transplant / cancer
  5. Voriconazole therapy (used to treat serious fungal infections)

Types of Mucormycosis

Mucormycosis can be categorized depending on which organ of the human body it attacks.  Signs and symptoms of the infection also vary depending on the affected body part.

Rhino orbital cerebral Mucormycosis: It infects the nose, orbit of eye / eye socket, oral cavity and can even spread to the brain. Symptoms include headache, nasal congestion, nasal discharge (green colour), pain in sinus, bleeding nose, swelling on face, lack of sensation on face and skin discoloration.                                         

Pulmonary Mucormycosis: This fungal infection affects the lungs. Causes fever, chest pain, cough and coughing of blood.

The fungus can also infect the gastrointestinal tract.

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Video: Massive Landslide in Sirmaur Caught on Camera, NH 707 Closed for Traffic

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Sirmaur landslide nh 707

Sirmaur-Incessant rains have caused another massive landslide in the Sirmaur district on National Highway 707. A 100 to 150 meters stretch of Paonta Sahib – Shillai road near Kali Dhank, Badwas, caved in within a few minutes.

According to the initial information received, no loss of lives or damage to any vehicle was reported as a minor slide from the hill had alerted the people.

The landslide completely damaged several electricity poles, causing a blackout in some parts of the region.

The district police is re-directing all traffic from Paonta Sahib to Shillai to the Puruwala-Kilod-Jong-Kafota-Shillai route.

Further, all traffic movement towards Shimla from the region has also been re-directed.

The HP Meteorological Department has issued a yellow alert for the state till August 2th, while widespread rain has been predicted till August 4th. 

The Met has also issued an alert for flash-floods for Chamba, Mandi, Kullu, Shimla, and Solan districts.

It’s pertinent to mention that furious monsoon has already claimed over 200 lives and caused damages to property worth hundreds of crores in Himachal Pradesh.

During the last two days, as many as 21 people had died due to landslides and flash floods triggered by cloudbursts. Some of the persons who were swept away or buried were yet to be traced.

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Himachal: Cloudbursts, Landslides Claim 9 Lives in 48 Hours, 7 Still Missing, Met Issues Alert Till August 1st  

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monsoon damage in himachal pradesh 2021

Shimla-Monsoon continues to pummel Himachal Pradesh with deadly ferocity, leading to more cloudbursts, landslides, and flash floods. Several rivers and rivulets are in spate. Incessant rains could bring more destruction as the HP Meteorological Department has forecast widespread heavy rains till August 1st. While a red alert was issued for July 28, an orange alert has been issued for July 29 and July 30 and a yellow alert for July 31st and August 1st.

An advisory has been issued for locals and tourists to not venture near the river banks and avoid unnecessary travel as incessant rains could lead to more landslides, flash floods, and uprooting of trees.  However, tourists could be seen resolutely ignoring these warnings and partying near river banks and water bodies.

As devastation unfolds, the death toll due to monsoon induced calamities has reached nearly 200, while damages to property were assessed to be in hundreds of crores. Over 350 roads, including Manali-Leh, Pathankot-Chamba, and Shimla-Kalka, were blocked due to landslides.  Half a dozen bridges, as many as 30 houses and several vehicles were destroyed. Hundreds of tourists were reportedly struck in Lahaul.

lahaul-spiti cloudburst

After a flash flood in Dharamshala, a massive landslide in Shahpur constituency, and a horrid rockslide in Kinnaur district that killed nine tourists and injured four people, a cloudburst triggered a flash flood in Lahaul-Spiti district on Tuesday that washed away over a dozen of people, who were said to be labourers.  

cloudburst in lahaul-spiti

According to the Director of the State Disaster Management, Sudesh Kumar, at the time of writing this report, seven bodies had been recovered while four others were missing. The cloudburst occurred over Tonzin nallah in the Lahaul region of the tribal district. Rescue operations were in progress to trace missing persons.

A team of the National Disaster Response Force, which was on its way to Lahaul-Spiti through road, remained stuck in Mandi for several hours.  

On Wednesday morning, cloudburst was reported in Kullu district resulting in deluging of Bhramhaganga – a tributary of Parvati river. A  tourist, a 25-year-old mother along with her 4-year-old son, and a hydropower official came in its spate and were yet to be traced. Beas river was also in spate and people living in shanties on its bank were evacuated. 

Beas in spate

Rackham area in Kinnaur district also reported heavy losses due to a cloudburst on Wednesday morning.

While a rockslide killed one person in Chamba’s Saluni, a helper tagged with a JCB deployed for clearing Bharmaur-Pathankot National Highway was swept away by gushing waters of a nullah on Tuesday night. His body was recovered on Wednesday.

In Shimla, a landslide between Vikasnagar and Panthaghati crushed a vehicle and caused damaged to some others. Gumma khud in Chirgaon was also in spate and reportedly swept away a bridge and about four vehicles. 

landslide in shimla crushed car

Dharamsala received the highest 122 mm of rain, followed by Una 119 mm. In Solan district, Kasauli and Nalagarh also received over 105 mm rain. 

This widespread destruction has worried climatologists and environmentalists who are linking increased instances of landslides and cloudburst to environmental degradation and destabilization of hills due to developmental projects, including cutting of hills for widening of roads, construction of four lanes, hydropower projects etc. 

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Kinnaur: Massive Landslide Caught on Camera, Kills 9 Tourists, Injures 4, Destroys Bailey Bridge

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kinnaur landslide in batseri

Kinnaur: A massive landslide in Batseri on Sangla-Chitkul road in the Kinnaur district of Himachal Pradesh on Sunday killed nine persons and injured at least four others. Huge boulders rolled down the mountain following the landslide and destroyed an iron Bailey bridge and many vehicles parked along the road within a few seconds.

A tourist vehicle, which was reportedly carrying about 11 tourists from Delhi NCR, Rajasthan, Maharashtra, and Chattisgarh, was hit by boulders near Gunsa, killing nine tourists. A couple of videos of this heart-wrenching incident went viral on social media. In the video, some people can be heard whistling and shouting to warn others.

“Nine people died, and three were injured after boulders rolled downhill due to a landslide in Kinnaur district. Batseri bridge collapsed in the incident. A rescue team is present at the spot,” Superintendent of Police (SP), Kinnaur, Saju Ram Rana said.

The intensity with which boulders hit could be assessed from the fact that the iron bailey bridge on the Baspa river collapsed instantly. 

Video of landlside in himachal pradesh

On receiving the information, teams of district police and Indo-Tibetan Border Police rushed to the spot and initiated a rescue operation. The district administration was also assessing the situation. As per reports, rocks sliding down from the hilltop made the rescue operation difficult for the teams.

sangla valley landslide

As per initial reports, a request was made to make a helicopter available to aid rescue work, which was yet to be fulfilled.

landslide in himachal pradesh

Chief Minister Jairam Thakur also expressed grief over the incident. An ex-gratia of Rs 2 lakh was announced for the deceased while injured would be given Rs. 50 thousand.

The exact cause behind the landslide was yet to be ascertained.

The deceased were identified as:

  1. Pratiksha Sunil Patil (27) from Sadhbhawna Nagar, Nagpur, Maharashtra
  2. Deepa Sharma (34) from Jaipur
  3. Amoghi Bapat (27) from Korba Darri in Chhatisgarh
  4. Umrab Singh (42) of Tagore Garden West Delhi
  5. Kumar Ulhas vedpathak (37)
  6. Anurag Biyani (31) from Sikar in Rajasthan, his mother Maya Devi Biyani (55) and his sister Richa Biyani (25)
  7. Satish Katakbar (34) from Chhatisgarh.

Those injured have been identified as Shiril Obroy (39) from West Delhi, Naveen Bhardwaj (37) from Kaharar in Mohali and Ranjeet Singh (45) from Batseri in Sangla.

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