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Faculty of Medicine invites people to idetify acute Hepatitis which cause is still unknown. - Universitas Indonesia
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Faculty of Medicine invites people to idetify acute Hepatitis which cause is still unknown.

Universitas Indonesia > News > Faculty of Medicine News > Faculty of Medicine invites people to idetify acute Hepatitis which cause is still unknown.

Recently, the world has been shaken by the emergence of cases of Severe Acute Hepatitis with obscure causes. This case has similar symptoms to normal Hepatitis, but is not caused by the same virus as Hepatitis. The World Health Organization (WHO) claimed this case as an Extraordinary Event on April 12, 2022. A total of 15 suspected cases were identified in Indonesia by per May 10, 2022. Of these 15 cases, 7 specimens were received by the laboratory of the Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital (FKUI–RSCM) as an effort to find a solution for handling the cases.

Continuing Medical Education (CME) FKUI invites health workers and health enthusiaststo discuss this case in the webinar “Emerging Infection: Severe Acute Hepatitis with unknown Cause”, on Thursday (12/05). The webinar, which was held via Zoom and YouTube @cmefkui, presented three speakers, namely Professor who is also a Pediatrician, Gastro-Hepatology Sub Specialist FKUI–RSCM, Prof. Dr. dr. Hanifah Oswari, SpA(K); FKUI Microbiology Specialist, Dr. dr. Budiman Bela, SpMK(K); and a lecturer at the Department of Community Medicine, FKUI, Dr. dr. Retno Asti Werdhani, M. Epid.

“This disease first appeared in Europe. Based on the latest data, currently Acute Hepatitis has spread in 20 countries. I got a contact from the Minister of Health who asked several experts from FKUI to discuss this case. Thank you to CME FKUI for responding quickly by holding this webinar so that information related to Acute Hepatitis can be disseminated immediately, especially for doctors and health workers so that they can educate the public,” said Prof. Dr. dr. Ari Fahrial Syam, SpPD-KGEH, MMB as the Dean of Faculty of Medicine.

With reference to WHO data, Prof. Hanifah said that currently there is no known way to confirm patients who have Severe Acute Hepatitis. Even so, there are phases that can be recognized as symptoms of this disease. In the initial phase, patients experience diarrhea, nausea, vomiting, fever, and breathing problems. When entering the advanced phase, there is a yellowish discoloration of the skin or eyes. Patients experience thick urination or pale stools, also experience seizures. In the last phase, the patient loses consciousness.

So far, scientists have found the presence of Adenovirus type 41 in the blood of the suspects. This virus and SARS-CoV-2 are thought to be one of the most likely causes of Severe Acute Hepatitis. Adenovirus is a virus commonly found in cases of vomiting and diarrhea, but it is not certain if it can cause Hepatitis. Departing from these findings, scientists state six hypotheses that cause Severe Acute Hepatitis. First, due to rarely being exposed to Adenovirus during a pandemic. Second, due to mutation of the new variant Adenovirus. Third, is the SARS-CoV-2 post-infection syndrome. Fourth, because of drug/environment exposure Fifth, the presence of new pathogens. Sixth, caused by a new variant of SARS-CoV-2.

According to Dr. Budiman, it is necessary to examine the possible causes of the disease according to the clinical symptoms found. He denied that there was a correlation between the Covid-19 vaccine and cases of Acute Hepatitis. The majority of patients are aged 3-5 years and most of them did not receive the Covid-19 vaccine. What’s more, the Adenovirus associated with most cases is Adenovirus Type 41, which is different from that used in some Covid-19 vaccines. Therefore, there is no proven correlation between the Covid-19 vaccine and cases of Severe Acute Hepatitis.

Severe Acute Hepatitis can be transmitted through the mouth from objects, food, or drinks that are contaminated with the faeces of a person infected with the virus and the respiratory tract Dr. Budiman advised health care facilities to use infection prevention and control standards, especially for all staff involved. It would be better if the child is cared for in a room that has a special bathroom and toilet. Dr. Budiman also appealed to the public to apply 3M (wear masks, wash hands and maintain distance); ensure that food and drink are not contaminated; and protect children from infection through the faecal-oral and respiratory tract.

There are three aspects that trigger the occurrence of disease, namely the patient, the cause, and the environment. Factors from the patient include knowledge and behaviour, personal hygiene, immunity and body nutrition, as well as a history of infection and vaccination. Disease-causing factors such as bacteria, viruses, and parasites affect the patient’s factor. Meanwhile, environmental factors can be in the form of case contacts, area, sanitation, clean water facilities, and food processing. Regarding environmental factors, each country’s policies have a major role in creating a healthy environment.

Dr. Asti suggested that parents teach healthy living habits to their children. These habits include how to wash hands properly, oral hygiene, toilet hygiene, and how to clean the body and trim nails.. The technique of washing food, the habit of wearing clean clothes, and sleeping in a clean place also need to be taught to children. Don’t forget to teach sneezing and coughing etiquette, and clean up habbit. At home and at school, it is important to maintain environmental cleanliness and sanitation.

Effort to prevent and fight severe acute Hepatitis cannot be done alone. According to Prof. Hanifa, cooperation from various parties is needed to deal with this disease. For the public, health workers, or researchers who find this case, they can report it to the Indonesian Pediatrician Association (IDAI) via bit.ly/Reporting Acute Hepatitis Cases or to the Indonesian Ministry of Health in the form of an epidemiological investigation (PE) form. If there are potential cases, the public can report to the Directorate General of Disease Prevention and Control (Dirjen P2P) through the Public Health Emergency Operation Center (PHEOC) by contacting WhatsApp (0877-7759-1097) or e-mailing poskoklb@yahoo.com.

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