WHO Determines Acute Hepatitis Is An Extraordinary Event, Ministry Of Health Intensive Investigation Asks People To Be Alert

Secretary of the Directorate General of Public Health Siti Nadia Tarmizi (Antara)

JAKARTA - The World Health Organization (WHO) has 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. For this reason, the Ministry of Health (Kemenkes) of the Republic of Indonesia has increased vigilance in the last two weeks.

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 jaundice, abdominal pain, sudden vomiting and diarrhea, old tea-colored urine, pale stools, seizures, decreased consciousness, they should immediately check with the nearest health service facility," said Nadia. .

Nadia added, 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 percent) required a liver transplant, and 1 case 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.

Meanwhile, 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 with SARS-CoV-2 and adenovirus," he continued.

For this reason, the Ministry of Health asks 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 skin and mucous membranes. Jaundice or yellow sclera and dark urine that appear suddenly and provide Communication, Information, and Education (IEC) to the community as well as prevention efforts through the implementation of Clean and Healthy Lifestyle.

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 such as hepatitis symptoms," said Nadia.