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Beware of acute hepatitis in children

The Ministry of Health has increased its vigilance in the past two weeks after the World Health Organization (WHO) declared an Extraordinary Event (KLB) in cases of Acute Hepatitis that attacks children in Europe, America and Asia, and the cause has not been known since April 15, 2022.

This vigilance increased after three pediatric patients who were treated at the Dr. Ciptomangunkusumo Jakarta with suspected acute hepatitis whose cause has not yet been determined, died in a different time period from the last two weeks to April 30, 2022.

These three patients are referrals from hospitals in East Jakarta and West Jakarta.

Symptoms found in these patients are nausea, vomiting, severe diarrhea, fever, jaundice, convulsions and loss of consciousness.

Currently, the Indonesian Ministry of Health is trying to investigate the causes of acute hepatitis through a complete virus panel examination. The DKI Jakarta Provincial Health Office is conducting further epidemiological investigations.

“During the investigation period, we urge the public to be careful and remain calm. Take preventive measures such as washing hands, ensuring food is cooked and clean, not changing eating utensils, avoiding contact with sick people and continuing to implement health protocols,” said Ministry of Health spokesman dr. Siti Nadia Tarmizi, M. Epid

If children have symptoms of jaundice, abdominal pain, sudden vomiting and diarrhea, old tea-colored urine, pale stools, seizures, decreased consciousness, they should immediately check the child to the nearest health service facility, said dr. Nadia.

Since it was officially published as an outbreak by WHO, the number of reports has continued to grow, with more than 170 cases reported by more than 12 countries.

WHO first received a report on 5 April 2022 from the United Kingdom regarding 10 cases of Acute Hepatitis of Unknown aetiology in children aged 11 months-5 years in the period January to March 2022 in Central Scotland.

The range of cases occurred in children aged 1 month to 16 years. Seventeen of them (10%) required liver transplantation, and 1 case was reported to have died. Clinical symptoms in the identified cases were acute hepatitis with elevated liver enzymes, acute jaundice (jaundice) syndrome, and gastrointestinal symptoms (abdominal pain, diarrhea and vomiting). In most cases, there are no symptoms of fever.

The cause of the disease is still unknown. Laboratory tests abroad have been carried out and hepatitis A, B, C, D and E viruses were not found to be the cause of the disease. Adenovirus was detected in 74 cases abroad which after molecular tests were identified as F type 41. SARS-CoV-2 was found in 20 cases, while 19 cases detected co-infection of SARS-CoV-2 and adenovirus.

The Ministry of Health through the Director General of Disease Prevention and Control issued Circular Letter Number HK.02.02/C/2515/2022 concerning Precautions for Finding Cases of Acute Hepatitis of Unknown Aetiology dated 27 April 2022.

The circular letter is intended to increase the support of the Regional Government, health service facilities, the Port Health Office, health human resources (HR), and other stakeholders regarding the early alertness of finding cases of Acute Hepatitis of Unknown Etiology..

The Ministry of Health asked the Provincial and District/City Health Offices, Port Health Offices, Public Health Laboratories and Hospitals to, among other things, monitor and report cases of acute jaundice syndrome in the Early Alert and Response System (SKDR), with symptoms marked by discolored skin and sclera. Jaundice or yellow and dark urine that appears suddenly and provides Communication, Information and Education (IEC) to the community as well as prevention efforts through the implementation of Clean and Healthy Living Behavior.

The Ministry of Health also asks related parties to inform the public to immediately visit the nearest Health Service Facility (Fasyankes) if they have Yellow Disease syndrome, and build and strengthen surveillance networks across programs and sectors.

“Of course we are strengthening surveillance through cross-programs and cross-sectors, so that immediate action can be taken if cases of acute jaundice syndrome are found or those with symptoms similar to hepatitis,” said dr. Nadia. The Health Office, KKP, and Hospitals are also asked to immediately provide notification/report if there is an increase in cases of acute jaundice syndrome or find cases according to operational definitions to the Director General of P2P through the Public Health Emergency Operation Center (PHEOC) via Tel./ WhatsApp 0877-7759- 1097 or e-mail: poskoklb@yahoo.com.

Source: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20220501/3939769/masyarakat-agar-waspada-setelah-3-pasien-anak-dengan-hepatitis-akut-meninggal-dunia/

Circular Letter HK.02.02/C/2515/2022 can be download through link belo:

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