The Union health ministry on Saturday said that coronavirus infection could make a person more susceptible to developing tuberculosis, as it was an “opportunistic infection like black fungus”, but added that there was not enough scientific evidence to link the two.

The government said that reports of a sudden increase in the number of tuberculosis cases among patients recovering from Covid-19 had left doctors worried.

The health ministry recommended tuberculosis screening for all Covid-19 patients and coronavirus screening for all diagnosed TB patients.

“The dual morbidity of tuberculosis and Covid-19 can be further highlighted through the facts that both the diseases are known to be infectious and primarily attack the lungs, presenting similar symptoms of cough, fever and difficulty in breathing, although TB has a longer incubation period and a slower onset of disease,” the government said.

The health ministry added that tuberculosis bacilli could be present in humans in a dormant state and “has the potential to start multiplying when the individual’s immunity is compromised for any reason”.

“The same is applicable in post-Covid scenario, when an individual may develop decreased immunity due the virus itself or due to the treatment, especially immune-suppressants like steroids,” the ministry added.

The government said that it has issued multiple advisories for the bi-directional screening of tuberculosis and Covid-19, which the states have been implementing.

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“Due to the impact of Covid-19 related restrictions, case notifications for TB had decreased by about 25% in 2020 but special efforts are being made to mitigate this impact through intensified case-finding in OPD [Out Patient Department] settings as well as through active case finding campaigns in the community by all States,” it added. “Moreover, there is not enough evidence currently to suggest that there has been an increase in TB cases due to Covid-19 or due to increased case finding efforts.”

Preliminary studies in India have shown that there is a 0.37% to 4% prevalence of tuberculosis among patients of the coronavirus disease, according to an analysis by IndiaSpend. Till October last year, 1.14% of the tuberculosis patients who were tested for Covid-19 were diagnosed with the infection.

India recorded 38,079 new coronavirus cases on Saturday, taking the tally of infections since the outbreak of the pandemic in January last year to 3,10,64,908. The country’s toll rose to 4,13,091 as 560 more patients died due to the infection.