JAKARTA - Pediatrician from the Indonesian Pediatrician Association (IDAI) Dr. Ade Rachmat Yudiyanto, Sp.A(K), M. Ked(Ped) reminded parents not to panic when they find the early symptoms of hepatitis in their children.

"If there are symptoms, don't panic. Immediately take the patient to the nearest health center and hospital for further assistance," he said in a webinar held by Dompet Dhuafa entitled "Acute Viral Hepatitis in Children and its Prevention and Treatment", Thursday 12 May.

Early symptoms of hepatitis are diarrhea, nausea, vomiting, abdominal pain and may be accompanied by a low-grade fever. If these symptoms appear, in addition to consulting a doctor or health worker at a health care facility, parents also need to ensure that the child is completely rested, maintains the child's fluid intake and body ions sufficiently so that he does not fall into a condition of dehydration or lack of fluids which in the long term can be dangerous. health. As for food, there are no special restrictions (based on the principle of balanced nutrition).

"Total rest. All activities are carried out in bed," said Ade.

According to Ade, parents should not wait for further symptoms to appear, such as yellow skin and eyes, until they lose consciousness, which could eventually require the patient to be admitted to the Intensive Care Unit (ICU) and even undergo a liver transplant.

Hepatitis is inflammation of the liver cells. Currently, there are parameters that can be used to confirm it, namely liver enzymes or Alanine Aminotransferase (ALT) or Serum Glutamate Pyruvate Transaminase (SGPT) if the value is above two times normal. Speaking of causes, hepatitis can be caused by infection and non-infection. Infection can be caused by viruses (A, B, C, D, E and G), bacteria or parasites, while non-infectious causes such as drugs, toxins, metabolism.

While looking at the current conditions, according to Ade, there is not even one accurate data that can clearly state the cause. Even doctors have not dared to do this in relation to SARS-CoV-2.

Acute hepatitis has recently been in the spotlight of the World Health Organization (WHO) and later designated it as an Extraordinary Event (KLB). The Ministry of Health has also increased vigilance on cases of Acute Hepatitis that attacks children in Europe, America and Asia, and the cause has not been identified since April 15, 2022. In Indonesia, on May 9, 15 cases were still suspected of being hepatitis and are still under investigation.

"In Indonesia, there are indeed cases that have been reported. But whether it is part of the acute hepatitis case whose cause is unknown, is still being investigated. Don't see the case in Indonesia as a terrible case but a case to be wary of," said Ade.

He hopes that this case report will not cause excessive concern among the public but rather will raise awareness.

"Hopefully this is just to make us vigilant, not to make our worries too much like COVID-19. I hope it doesn't continue like COVID-19 because this is something that needs vigilance," said Ade.

Referring to the WHO definition, there are three classifications related to acute hepatitis, namely confirmation for which data has not yet been found, probable and Epi-linked. Ade explained, it is said to be probable if it meets a number of conditions, including: proven acute hepatitis, unknown cause, not the cause of viral hepatitis A, B, C, D and E.

Then, other data such as laboratory tests found SGOT or SGPT of more than 500 IU/L, occurred at the age of under 16 years and cases were found above October 1, 2021. Meanwhile, it was said to be Epi-linked or close contact, namely hepatitis acute at all ages and close contact with probable cases over October 1, 2021.


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