Regions On Alert Over Acute Hepatitis Among Children

KOMPAS/HENDRA A SETYAWAN (HAS)

Officers from the Depok City Health Service and the Cinere Health Center conducted field checks and investigations regarding reports of hepatitis A that attacked residents in RT 1 and RT 2/RW 1, Cinere, Depok, West Java, Wednesday (28/8/2019).

Prevention and anticipation of the transmission of mysterious acute hepatitis need to be done as early as possible. Parents need to recognize the symptoms of this disease and maintain food hygiene while still adhering to health protocols.

JAKARTA, KOMPAS — A number of regions are preparing themselves to prevent and anticipate the transmission of mysterious acute hepatitis among children. Parents should also recognize changes in their children's health conditions and immediately take them to a medical service if they encounter symptoms of this disease.

Symptoms include nausea, vomiting, diarrhea, dark-colored urine, pale stools and jaundice (yellowish color of the sclera of the eyes and skin). Other symptoms that may appear include joint pain or aches, abdominal pain, lethargy, loss of appetite and seizures.

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In addition, the laboratory examination found an increase in liver enzymes SGOT or SGPT of more than 500 micro per liter.

Since the World Health Organization (WHO) issued a warning regarding this mysterious acute hepatitis among children on April 23, reports related to this inflammatory liver disease have continued to grow. This case was first reported in the United Kingdom on April 5. As of May 3, more than 200 cases were reported from 20 countries, including Indonesia. Three children in Jakarta died of suspected mysterious acute hepatitis (Kompas, 4 May 2022).

Results of the preliminary investigation revealed that this disease may be caused by adenovirus type 41F.

The executive director of the International Pediatric Association (IPA), who is also a professor of the Faculty of Medicine, the University of Indonesia, in the field of Child Health Sciences, Aman Bhakti Pulungan, said that investigations were still being carried out to identify the causes of acute hepatitis in a number of countries. Results of the preliminary investigation revealed that this disease may be caused by adenovirus type 41F.

“This type of virus is often found in everyday life, and usually causes symptoms of diarrhea, vomiting, fever and respiratory tract symptoms. However, adenovirus usually does not cause hepatitis in healthy children," he said, on Wednesday (4/5/2022).

HERYUNANTO

The illustration about hepatitis

Aman said that the adenovirus found was different from the adenovirus strain used in the COVID-19 vaccine made by AstraZeneca. Therefore, hepatitis is not related to the vaccine. Moreover, most of the pediatric patients are under the age of five and have not received the COVID-19 vaccine.

Advisor for the Prevention and Control of Hepatitis Virus from the Pan American Health Organization (PAHO) Leandro Soares Sereno, on Tuesday (3/5), said that severe adenovirus infections that can cause hepatitis generally occurred in patients with compromised immune systems or transplant patients. However, in children, it is found that acute hepatitis is not associated with the condition. Laboratory tests reveal that it was not related to the hepatitis A, B, C, D or E viruses.

"The data [of cases] that are available are still minimal to determine whether an outbreak has occurred. The global risk is still considered low, because there is no certainty about the origin of the disease. The most important thing, especially for parents, is to recognize the symptoms of this disease,” he said.

Additional case

Secretary of the directorate general of public health at the Health Ministry, Siti Nadia Tarmizi, said that an epidemiological investigation had been carried out on three cases of children who died due to suspected cases of hepatitis, with unknown causes. The investigation into one case is nearly complete, and reveals that no family member suffers from the same illness, either before or after the child is sick.

“Until now, three suspects have been reported. There are additional cases in Jakarta with symptoms of hepatitis, but no further information has been reported," she said.

This was conveyed through a circular letter of the directorate general of Disease Prevention and Control.

The Health Ministry asks all stakeholders to increase awareness of this disease. This was conveyed through a circular letter of the directorate general of Disease Prevention and Control.

"We have submitted the Circular to the regencies, municipalities and hospitals throughout West Java. Coordination and monitoring are also carried out with the KKP [Port Health Office]," said head of the West Java Health Service R Nina Susana Dewi.

Head of the Bandung City Health Office, Ahyani Raksanagara, stated that his party had coordinated with health facilities to carry out monitoring.

Head of the Surabaya city health office, Nanik Sukristina, said that the health office was coordinating with all facilities to increase vigilance. Hospitals are asked to increase surveillance of all cases of jaundice syndrome (the skin looks yellowish).

General chairperson of the central executive board of the Indonesian Pediatrician Association (PP IDAI), Piprim Basarah Yanuarso, in a press release, stated that all pediatricians on assignment needed to participate in supervising patients if symptoms of acute hepatitis were found. The public also needs to be vigilant so that when these symptoms appear, they can immediately take the child to a health-care facility.

Various preventive measures also need to be considered. Make sure to always maintain cleanliness by diligently washing hands using soap and running water, always consuming boiled drinking water, consuming clean and cooked food, not sharing eating utensils with others and disposing of feces or disposable diapers in designated place. The health protocols of wearing masks and keeping distance also need to be followed. (TAN/BRO/ETA/RTG)

(This article was translated by Kurniawan Siswo)