Ministry Of Health Issues SE Alerts On The Discovery Of Acute Hepatitis

JAKARTA - The Ministry of Health (Kemenkes) through the Directorate General of Disease Prevention and Control (Dirjen P2P) issued Circular Letter (SE) Number HK.02.02/C/2515/2022 concerning Precautions for the Discovery of Acute Hepatitis of Unknown Cases. aetiology).

The SE was signed by the Director General (Dirjen) of P2P Maxi Rein Rondonuwu on April 27, 2022.

"This Circular is intended to increase the support of local governments, health service facilities, Port Health Offices, health human resources (HR), and stakeholders related to early vigilance in the discovery of cases of Acute Hepatitis of Unknown Etiology," stated the SE, quoted from the page. Cabinet Secretary, Wednesday, May 4.

The Ministry of Health asked the provincial and district/city health offices, the Port Health Office (KKP), public health laboratories, and other hospitals to monitor and report cases of acute jaundice syndrome in the Early Alert and Response System (SKDR), with symptoms marked by icteric or yellow skin and sclera and dark urine that appear suddenly and provide Communication, Information, and Education (IEC) to the public as well as prevention efforts through the application 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 experience jaundice, and build and strengthen surveillance networks across programs and sectors.

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) by telephone/WhatsApp 0877-7759-1097 or e-mail poskoklb@yahoo.com.

Meanwhile, Spokesperson for the Ministry of Health, Siti Nadia Tarmizi, said that the Ministry of Health had increased vigilance in the last two weeks after the World Health Organization (WHO) declared an Extraordinary Event (KLB) in cases of acute hepatitis that attacked children in Europe, America and Asia, and the cause has not been known since April 15, 2022.

"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, quoted from the official website of the Ministry of Health, Wednesday, May 4.

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 were 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.

Nadia emphasized that the Ministry of Health carried out an investigation into 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 precautions 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," he said.

Nadia asked that if there are children who have symptoms of jaundice, abdominal pain, sudden vomiting and diarrhea, old tea-colored urine, pale stools, seizures, decreased consciousness, they should immediately be checked to the nearest health facility.

WHO first received a report on 5 April 2022 from the United Kingdom regarding ten cases of acute hepatitis of unknown etiology in children aged 11 months-5 years in the period January to March 2022 in Central Scotland. Since it was officially published as an outbreak by WHO, the number of reports has continued to grow. More than 170 cases have been reported by more than 12 countries.

The range of cases occurred in children aged 1 month to 16 years. Seventeen of these children or 10 percent required liver transplantation and one 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. (PUBLIC OF INDONESIA MINISTRY OF HEALTH/UN)