From January to December 2017, Health Ministry recorded 450 cases of the extraordinary occurrence of diphtheria in children aged 5-9.
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JAKARTA, KOMPAS – Diphtheria has spread in the country over the last few months. From January to December 2017, the Health Ministry recorded 450 cases of the extraordinary occurrence of diphtheria in children aged 5-9, the most common sufferers of the disease. Owing to this, the government will carry out immunization in areas that are infected by the disease.
The Health Ministry’s director general of disease prevention and control, Mohamad Subuh, Sunday (3/12) in Jakarta, said that 19 provinces, including Banten, Jakarta, East Java, West Java and West Sumatera, had reported a suspected extraordinary occurrence (KLB) of diphtheria in their respective regions. “Evaluation is being carried out to confirm the reports,” he said.
The government will soon provide outbreak response immunization (ORI) through diphtheria, pertussis, tetanus (DPT)/diphtheria-tetanus (DT) re-immunization to all children aged below 15 years old living in extraordinary situation (KLB) status areas.
Diphtheria is an infectious disease caused by the bacterium Corynebacterium diphtheriae that affects the throat and nose. The infection causes a thick covering in the back of the throat, blocking airways. As a result, a person with such an infection would suffer from breathing difficulties, which could lead to death.
Planned and termed
Indonesian Pediatrician Association (IDAI) chairman Aman Bhakti Pulungan stressed that the extraordinary diphtheria situation must be handled with good short term and long term planning. It is hoped that the government will immediately start ORI in regions that have reported extraordinary situations. Moreover, law enforcement me carried out in regions that have not provided the obligatory immunization.
"For regions that have been infected with diphtheria, particularly those that have not reached the immunization coverage, the leaders of those regions need to be dealt with,” he said.
Every child must get the DPT immunization three times before the age of 1, once in their second year and another time when they are 5 years old or before they start elementary school. “Elementary school-age children need to get diphtheria immunization through the School Children Immunization Month program. If this is not done, the diphtheria immunization will not run optimally, Aman said.
The Health Ministry’s director of surveillance and quarantine, Elizabeth Jane Soepardi, added that the coverage of the DPT/DT immunization is above 90 percent. However, there has been a sporadic immunity disparity in society. The aspect of mobility, sanitation hygiene and anti-vaccine movements have affected the spread of diphtheria.
The anti-vaccine movements that have surfaced recently need to be given attention. This is because it turns out that around 60 percent of patients infected with diphtheria in the past year had never received immunization.
According to Subuh, there are a number of causes of diphtheria. Firstly, it may be caused by the child not getting any immunization whatsoever. Secondly, the immunization received may be incomplete. Thirdly, the immunization may be complete but not optimal. “Only five percent have had complete immunization, but are still infected with diphtheria. This is what we will be evaluating,” he said.
Several regions
In the last few years, some regions have reported cases of diphtheria, despite cases of the disease being very rarely found since back in the 1990s.
In a number of regions, the people have not been open-minded regarding the spread of diphtheria. Saifulloh, head of prevention, disease eradication and environmental health at the health agency of Nganjuk regency, East Java, admitted that some people refuse the immunization. Nganjuk has been declared to be in an extraordinary diphtheria situation since there had been a diphtheria case there in September.
Faliq Ubaydillah, 3, a toddler from Bojonegoro who lived in a rented house in Kapas village, Sukomoro district, Nganjuk died of diphtheria. “Immunization is effective in preventing diphtheria, so (health) workers must find ways to deal with people who refuse the immunization,” Saifulloh said.
Malang city health agency head Asih Tri Rachmi said some students in Malang city, East Java, were suspected to have been infected with diphtheria, including students from SMA Negeri 3 senior high school and SMP Negeri 4 junior high school. To prevent the spread of the cases of diphtheria, immunization is done in the schools. The local health agency urged the locals to go to the community health centers (Puskesmas) to get diphtheria immunization for free. The puskesmas team will monitor schools infected with diphtheria.
Cases of diphtheria were found in Malang because the immunization coverage is not yet 100 percent due to a number of parents who have refused the immunization for their children. Now, Puskesmas are giving re-immunizations in schools that are suspected to be infected by the diphtheria bacterium.
The South Kalimantan health agency confirmed that his region no longer has an extraordinary situation (KLB) status for diphtheria this year, even though there is one case of suspected diphtheria in Banjarbaru city. South Kalimantan health agency acting head Muhammad Muslim in Banjarmasin said that the recent suspected case of diphtheria in Banjarbaru, in which a child was supposedly infected with the disease, has undergone laboratory examination and has shown negative results.