Latest Developments About Mysterious Hepatitis in Children — Mysterious hepatitis in children is now a hot topic of conversation around the world. The World Health Organization (WHO) stated that the Extraordinary Event (KLB) in this acute hepatitis case attacked children in Europe, America and Asia, whose cause had not been known since April 15, 2022.

In early May, 169 cases were reported worldwide, with 17 children requiring a liver transplant and one case resulting in the death of a child. In the latest case in Indonesia, the Ministry of Health reported that as many as three children died from being infected with this mysterious hepatitis. Through its official website, the Ministry of Health has also increased its vigilance in the two weeks following the mysterious hepatitis case in the child.

What causes hepatitis in children?

The cause of mysterious hepatitis in children is still not known with certainty. 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.

Meanwhile, studies in the United States suspect, the virus is behind the outbreak of a mysterious hepatitis disease that infects children aged 1 month to 16 years. The study was conducted by the US Centers for Disease Control and Prevention (CDC) specifically on acute hepatitis emerging in Alabama.

The CDC also investigated a cluster of cases of mysterious liver disease in these children, and based on their study, all of the younger children tested positive for a common pathogen called adenovirus 41.

Adenovirus 41 virus was discovered and is known to cause gastroenteritis in children. 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.

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Meanwhile, the Indonesian Ministry of Health and the Indonesian Health Service are investigating this mysterious hepatitis case further. The goal is to include a more detailed travel history and additional virological or microbiological tests.

Symptoms of mysterious hepatitis in children

To be aware of the transmission of this mysterious hepatitis in children, parents must be alert and respond immediately if their children experience symptoms, including the following.

  • Loss of consciousness
  • High fever or history of fever
  • Changes in the color of urine (dark) and/or stool (pale)
  • yellow skin
  • Itch
  • Joint pain or aches
  • Nausea
  • vomiting or abdominal pain
  • Lethargy or loss of appetite
  • Diarrhea in childrenDiare pada anak

What to do when you find signs of hepatitis in a child?

Parents have an important role in preventing mysterious hepatitis in children, so doctors have room to treat and treat more patients. Citing a video on the Ministry of Health’s YouTube, press conference “Update on the Development of Acute Hepatitis Cases in Indonesia”, (5/5/2022) Prof.

dr. Hanifah asked all parents to be aware of the early symptoms of hepatitis or mysterious liver disease in children. Early symptoms of hepatitis in children usually infect the digestive tract.

Characterized by the appearance of symptoms of diarrhea, nausea, vomiting, abdominal pain, and low-grade fever that leads to acute hepatitis of unknown cause.

Immediately take your child to the nearest health facility for help from health workers. Do not delay until more severe symptoms appear, such as yellowing of the skin. If that happens, then the doctor will not have much opportunity to provide help to your children.

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How to prevent transmission

To prevent the transmission of mysterious liver disease to children, a series of steps can be taken at home. The Indonesian Pediatrician Association (IDAI) issued guidelines for preventing mysterious acute hepatitis in children.

The guidelines are at least to provide public awareness of the appeal of the Indonesian Ministry of Health on this mysterious case of liver disease in children in Indonesia.

There are also six recommended ways to prevent the transmission of the mysterious hepatitis. Here’s a summary of how to prevent it that can be applied to your child.

  • Wash hands with running water and soap
  • drink clean water
  • Ensure food is cooked and clean
  • Do not change cutlery
  • wearing a mask
  • Keep the distance

The flow of treatment for acute hepatitis in children

On May 5, 2022, IDAI issued a recommendation for screening for cases of acute hepatitis in children with no known cause. According to IDAI recommendations, the steps to find out if a child has this mysterious hepatitis are as follows.

  1. Children 16 years old.
  2. Have one or more of the following symptoms:
      • jaundice,
      • acute stomach pain,
      • acute diarrhea,
      • nausea or vomiting,
      • loss of consciousness or seizures,
      • lethargy or malaise, and myalgia or arthralgia.
  3.  If the child has one or more of these symptoms, the next step is the ALT (SGPT) and AST (SGOT) examination.
  4. If the results of the examination show that the ALT (SGPT) or AST (SGOT) level is not more than 500 U/L, the examination can be stopped. However, if later the levels increase above normal, it is necessary to monitor ALT and AST levels periodically.
  5. Meanwhile, if the results of the examination show that the ALT (SGPT) or AST (SGOT) level is more than 500 U/L, the following further examinations are necessary:
      • anti-HAV IgM,
      • HBsAg,
      • IgM anti-HBc (if HBsAg positive),
      • Anti-HCV or HCV RNA,
      • IgM anti-HDV (if HBsAg positive), and
      • IgM anti-HEV¹.
  6. The results of the minimal inspection that exist indicate the following conditions:²
      • IgM anti-HAV negative,
      • HBsAg negative or IgM anti-HBc (in HBsAg positive), and
      • Anti-HCV or HCV RNA negative.
  7.  If the results do not show the above conditions, the child needs to be treated as acute viral hepatitis.
  8. Meanwhile, if the results show the conditions above, the child may have acute viral hepatitis whose cause is unknown
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Additional information:

1: Hepatitis D and hepatitis E tests are currently not widely available in Indonesia.

2: because there are still limited tests for hepatitis D and E, the initial screening is enough to check for hepatitis A, B, and C.

3: Must be reported regardless of other causes.

If you have further questions regarding this mysterious hepatitis in children, please consult your pediatrician.

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