Indonesia bans sale of all cough syrups after 199 child deaths

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Doctors In Bali Raise Concerns Over Rising Cases Of Kidney Disease In Local Children

Posted onPublished: October 17, 2022

Doctors in Bali have raised formal concerns about rising cases of kidney disease in young children. Doctors have reported that since August 2022, there have been 17 cases where an unnamed kidney disorder has hospitalized children. Heartbreakingly, 11 children have died.

The Head of the Bali Provincial Health Office, Dr. I Nyoman Gede Anom, told reporters that research is ongoing to establish what is causing the mysterious kidney disease and what can be done to prevent these cases from rising. He has speculated that parents have been giving their children drugs to solve common ailments without a prescription from a doctor.

He suggested that the wrong, unprescribed medication with an unspecified dosage could be causing kidney disease in these cases. He noted that clinicians had observed a similar phenomenon in Gambia, West Africa.
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https://thebalisun.com/doctors-in-ba...ocal-children/

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See also:

Gambia - Government investigates as children die of mysterious disease - WHO issues a medical product alert for four contaminated medicines

https://flutrackers.com/forum/forum/...ated-medicines

 

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West Sumatra reports 22 acute kidney failure cases in children

6 hours ago
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Padang, West Sumatra (ANTARA) - The Health Office of West Sumatra Province has, so far, recorded as many as 22 cases of acute kidney failure among children, and 12 of them had succumbed to the disease.
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The doctor noted that of the 20 children treated in the hospital due to acute kidney failure, one patient was under one year of age, nine patients were aged 1-5 years, four patients, aged 5-10 years, and six patients were above 10 years of age.

He noted that around 50 percent of the patients experienced diarrhea, and there were some that suffered from upper respiratory tract infections.
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https://en.antaranews.com/news/255897/west-sumatra-reports-22-acute-kidney-failure-cases-in-children

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Published October 20, 2022 2:14 AM

Indonesia bans sale of all cough syrups after 99 child deaths

By Heather Chen and Masrur Jamaluddin, CNN

Indonesia has halted the sale of all syrup and liquid medicines following the deaths of nearly 100 children and an unexplained spike in cases of acute kidney injuries.

The ban, announced by the country’s Health Ministry on Wednesday, will remain until authorities complete an investigation into unregistered medical syrups suspected of containing toxic ingredients.

Health Ministry spokesperson Mohammad Syahril said 99 deaths and 206 cases of acute kidney injuries in children, mostly under the age of 6, were being investigated.
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https://abc17news.com/news/2022/10/20/indonesia-bans-sale-of-all-cough-syrups-after-99-child-deaths/

 

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Translation Google

The Ministry of Health Takes Anticipatory Policies to Prevent Kidney Disorders in Children

Published On : Wednesday, 19 October 2022 00:00:00, Read : 7,184 Times

Jakarta, October 19, 2022

Since the end of August 2022, the Ministry of Health and the Indonesian Pediatrician Association (IDAI) have received reports of a sharp increase in cases of Atypical Progressive Acute Kidney Injury (AKI) in children, especially under the age of 5 years. This increase in cases is different from the previous one, and the cause is still under investigation and research.

The number of cases reported until October 18, 2022 was 206 from 20 provinces with a mortality rate of 99 children, where the mortality rate of patients treated at the RSCM reached 65%.

"From the results of the examination, there is no evidence of a relationship between the incidence of AKI with the COVID-19 vaccine or COVID-19 infection. Because AKI disorders generally attack children aged less than 6 years, while the vaccination program has not yet targeted children aged 1-5 years,'' said a spokesman for the Ministry of Health, dr Syahril.

The Ministry of Health together with BPOM, Epidemiology Experts, IDAI, Pharmacologists and the National Police Laboratory for carrying out laboratory tests to determine the exact cause and risk factors that cause acute kidney disorders.

In the examination carried out on the remaining samples of drugs consumed by the patient, while traces of compounds that have the potential to cause AKI were found. Currently, the Ministry of Health and BPOM are still continuing to explore and research comprehensively, including the possibility of other risk factors.

To increase vigilance and in the context of prevention, the Ministry of Health has asked health workers at health care facilities to temporarily refrain from prescribing drugs in the form of liquid/syrup preparations, until the results of the search and research are complete.

The Ministry of Health also asked all pharmacies to temporarily not sell over-the-counter and/or limited-free drugs in liquid/syrup form to the public until the results of the search and research are complete.

''The Ministry of Health urges the public to treat children, while not taking drugs in the form of liquid/syrup without consulting health workers,''said dr Syahril.

''As an alternative, you can use other dosage forms such as tablets, capsules, suppositories (anal), or others,'' he said.

The need for vigilance for parents who have children under five with symptoms of decreased amount of urine and frequency of urination with or without fever, diarrhea, cold cough, nausea and vomiting to be immediately referred to the nearest health facility.

The patient's family is asked to bring or inform the drug consumed previously, and convey a history of drug use to health workers.

As an initial step to reduce AKI fatalities, the Ministry of Health through the RSCM has purchased antidotes imported directly from abroad.

The Ministry of Health has issued a Decree of the Director General of Health and Health on the Management and Clinical Management of AKI in children, which is addressed to all health offices and health facilities. The Ministry of Health has also issued a circular on the obligation of epidemiological investigations and reporting of AKI cases addressed to all Health Offices, Health Facilities, and Professional Organizations.

Corona Virus Hotline 119 ext 9. This news was broadcast by the Bureau of Communications and Public Services, Ministry of Health of the Republic of Indonesia. For further information, please contact the Halo Ministry of Health hotline number via hotline 1500-567, SMS 081281562620, facsimile (021) 5223002, 52921669, and contact email address [at] Kemkes [dot] go [dot] id

https://www.kemkes.go.id/article/vi...if-untuk-cegah-gangguan-ginjal-pada-anak.html

 

[Emily]

https://www.thestar.com.my/aseanplu.../23/child-deaths-blamed-on-syrups-rise-to-133

Child deaths blamed on syrups rise to 133
Indonesia

• Sunday, 23 Oct 2022

The number of child deaths from acute kidney injuries in Indonesia has risen to 133, the health minister said, attributing the fatalities to harmful substances found in medicinal syrups.

Indonesia saw a spike in acute kidney injury (AKI) cases this year, prompting a probe and ban on all syrup and liquid medicine prescriptions and sales.

“We have identified 241 cases of acute kidney injury in 22 provinces, with 133 fatalities,” Health Minister Budi Gunadi Sadikin told a press conference on Friday.

Budi said authorities found traces of harmful substances in children being treated for AKI.

“Seven out of 11 children had that harmful substance: ethylene glycol, diethylene glycol and ethylene glycol butyl ether.

“It is confirmed that (AKI) was caused by (those) substances.”...

 

[Emily]

https://en.antaranews.com/news/2563...-drugs-to-arrive-in-indonesia-sunday-minister
Acute kidney injury drugs to arrive in Indonesia Sunday: Minister

1 hour ago
Jakarta (ANTARA) - A total of 26 Fomepizole drug vials to medicate atypical progressive acute kidney injury will arrive in Indonesia on Sunday, Minister of Health Budi Gunadi Sadikin informed..

The 26 Fomepizole drug vials comprise 10 from Singapore and 16 from Australia, he told the press after an event commemorating the National Osteoporosis Day here on Sunday.

He noted that the drugs that will help the recovery of acute kidney injury patients are rare drugs. He lauded and thanked the assistance from Singapore and Australia.

"I called the Singapore and Australian ministers of health and they gave it immediately," he remarked...

 

[Emily]

According to the article below, the medicine was made in Indonesia. With this problem in Gambia, also, there could be a contaminated supply chain. I've been afraid of this happening now, much like the timing of the international melamine and drug poisonings back in 2007. Financial crises are dangerous. The melamine in pet food spread from one US importer to large US corporations and then the food went around the world.

https://en.antaranews.com/news/2562...cute-kidney-injury-in-241-indonesian-children

 

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Translation Google

New Cases of Acute Kidney Disorders Decreasing

Published On : Thursday, 27 October 2022 00:00:00, Read : 146 Times

Jakarta, 27 October 2022

The Ministry of Health again provides an update on developments related to the handling of cases of Atypical Progressive Acute Kidney Disorder (ARF) in Children in Indonesia. As of Wednesday (26/10), 18 cases of ARF were reported, bringing the total to 269 cases.

Ministry Spokesman, dr. Mohammad Syahril explained that the 18 cases reported were not new cases, but an accumulation of previous cases that had just been reported to the Ministry of Health.

''Of these 18 cases, only 3 are new cases. I repeat only 3 new cases, while the rest are old cases in September and early October which were newly reported,'' said Spokesman Syahril.

Spokesman Syahril explained that the case occurred after the Director General of Health Services SE dated October 18, 2022, which asked health facilities not to provide drugs in the form of liquid/syrup. Thus, after October 18, there were only 3 new cases of ARF in children.

''We emphasize that after October 18, there will only be 3 new cases. All three are currently undergoing treatment,''said Spokesman Syahril.

He added that the tendency for no additional cases was high, as a result of the policy of temporarily stopping the use of syrup drugs in children.

Although under control, Spokesman Syahril said the government continues to monitor the development of ARF cases, especially in the 5 provinces with the highest number of cases, namely DKI Jakarta, Aceh, Bali, Banten and West Java.

Anticipatory policies are still being implemented by the Ministry of Health to reduce morbidity and mortality due to ARF.

In terms of tracing, since last August the Ministry of Health together with all health offices and hospitals have carried out surveillance activities to record all provinces/regencies/cities that reported ARF cases to speed up this handling. This surveillance activity was followed up with laboratory examinations as well as examinations for possible intoxication of toxic substances, to determine the exact cause of ARF cases.

From a therapeutic point of view, as a first step, the Ministry of Health has brought in 30 vials of Antidotum Fomepizole from Singapore which will be coming in stages.

Spokesman Syahril detailed, as many as 20 vials arrived in Indonesia on October 10 and 18 and have been used for treatment at the RSCM. As a result, the condition of ARF patients has improved.

Furthermore, 10 more vials which are scheduled to arrive on the day will be distributed to government referral hospitals that treat ARF patients.

Besides Singapore, the Ministry of Health also brought 16 vials of Antidotum Fomepizole from Australia on October 22 and has been distributed to a number of hospitals including M. Djamil Hospital in Padang, Soetomo Hospital in Surabaya, Adam Malik Hospital in Medan, and Zainul Abidin Hospital in Aceh.

Not only that, as a result of bilateral diplomacy with Canada during the G20 Health Ministers' Meeting, Indonesia also received a donation from Takeda in the form of 200 vials of Antidotum Fomepizole which will arrive next week.

Upon arrival in Indonesia, this injection drug will be directly distributed to all government hospitals and given free to all patients.

''Fomepizole is completely free of charge to patients as part of therapy/treatment,'' said Spokesman Syahril.

In addition to anticipatory efforts from the government, his party urges the public to remain calm, there is no need to panic excessively. Most importantly, the community can fully participate in anticipating ARF in children by always being vigilant and temporarily not giving drugs in liquid/syrup form to children.

Finally, Spokesman Syahril emphasized that the support of all parties will also determine the success of handling ARF in Indonesia.

''It is hoped that all parties can synergize and collaborate to save the lives of Indonesian children as a top priority. Our goal is for the future health of our children,'' closed Spokesman Syahril.

This news was broadcast by the Bureau of Communications and Public Services, Ministry of Health of the Republic of Indonesia. For further information, please contact the Halo Ministry of Health hotline number via hotline 1500-567, SMS 081281562620, facsimile (021) 5223002, 52921669, and contact email address [at] Kemkes [dot] go [dot] id . (MF)

https://www.kemkes.go.id/article/view/22102700005/kasus-baru-gangguan-ginjal-akut-menurun.html

 

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Acute kidney disease cases in Indonesia increase to 269: Ministry

27th October 2022

Jakarta (ANTARA) - The Health Ministry's spokesperson, Mohammad Syahril, said 269 cases of atypical progressive acute kidney disease were recorded in Indonesia as of October 26, 2022, an increase of 18 cases from that of the earlier two days.

Of the total number, 73 patients were still being treated, 157 died, and 39 patients recovered, he remarked.

"On October 24, some 241 cases were recorded, an increase of 18 cases from the previous two days. However, out of the 18 cases, only three new cases were found after October 24 or after the circular stated a ban on syrup drugs sales," Syahril noted in a press conference here, Thursday.

He explained that the additional 15 cases were those that occurred at the end of September to mid-October but had only been reported to the government. Hence, the number of additional cases after the government ban on syrup drugs was only three.

Related news: Ministry to directly distribute AKI antidote to health facilities

Cases of acute kidney disorders in children under five years of age occurred in 27 provinces in Indonesia. The distribution of the cases mostly occurs in Jakarta with 57 cases, while 36 cases in West Java, 30 cases in Aceh, 25 cases in East Java, and 19 cases in West Sumatra.
...

https://en.antaranews.com/news/2571...e-cases-in-indonesia-increase-to-269-ministry

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Translation Google


200 vials of Fomepizole Arrive in Indonesia

Published On : Saturday, October 29, 2022 00:00:00, Read : 223 Times

Jakarta, October 29, 2022

The injection for acute kidney disease, Fomepizole 1.5 ml, in vial has arrived in Indonesia on Saturday (29/10) early in the morning. A total of 200 vials were imported from Japan which was a donation from PT Takeda Indonesia.

Fomepizole will be sent directly to the Central Pharmacy installation. The drug came out directly from the airport at 2 am on Saturday (29/10), after going through the process at the airport.

''This grant is implemented in good faith in the name of humanity for the benefit of the health of Indonesian children,'' said the Minister of Health.

The Ministry of Health through the Directorate General of Pharmacy and Medical Devices will distribute the drugs as needed to all provincial referral homes in Indonesia.

''This antidote drug will be given free of charge to all patients in Indonesia,'' said the Minister of Health on Saturday (29/10) in Jakarta.

Previously, it was known that 10 out of 11 patients with acute kidney disease who took syrup drugs suspected of being contaminated with certain chemical compounds gradually improved after being given this drug while being treated at the RSCM referral hospital. Three children no longer need a ventilator and 1 person has been discharged.

It can be concluded that this drug (Fomepizole) has a positive impact on the treatment of patients with acute renal impairment.

Indonesia has imported fomepizole from Singapore, Australia and Japan. Currently being explored the opportunity to bring in Fomepizole from the United States and Canada.

''This is an effort that we are doing to prevent the increase in cases of atypical progressive acute kidney disorders. We will be distributed to all government hospitals that treat patients with acute kidney disorders,'' said the Minister of Health.

This news was broadcast by the Bureau of Communications and Public Services, Ministry of Health of the Republic of Indonesia. For further information, please contact the Halo Ministry of Health hotline number via hotline 1500-567, SMS 081281562620, facsimile (021) 5223002, 52921669, and contact email address [at] Kemkes [dot] go [dot] id (D2).

https://www.kemkes.go.id/article/view/22102900001/200-vial-fomepizole-tiba-di-indonesia.html

 

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Translation Google

New Cases and Deaths Drop After Discontinuation of Syrup Drugs

Published On : Sunday, November 6, 2022 00:00:00, Read : 464 Times

Jakarta, November 6, 2022

Various anticipatory measures to reduce the morbidity and mortality of Acute Kidney Failure in Children (ARF) have resulted in a drastic reduction in new cases and deaths.

The decline occurred mainly since the issuance of the Circular Letter of the Directorate General of Health Services on October 18, 2022 which temporarily stopped the use of syrup drugs to all Health Offices, Health Service Facilities, and Health Professional Organizations.

Minister of Health Budi G. Sadikin stated that his party continues to strive to reduce new cases of GGAPA caused by the consumption of syrup drugs to zero.

The Minister of Health asked all provincial and district/city health offices to carry out strict supervision of drug administration by pharmacies and health workers in their respective regions.

“Last week's new cases occurred on 29 October and 1 November. That's because the patient is still taking syrup from the pharmacy. Please help the provincial and district/city health offices to control the administration of drugs at our pharmacies and midwives. To protect our toddlers,'' said Minister of Health Budi.

Data reported from all hospitals in 28 provinces, showed consistent examination results, the biggest risk factor causing ARF is toxicity from EG and DEG in syrup/liquid drugs.

There has been a decrease in mortality since the use of the antidote Fomepizole as a treatment for GGAPA. Since October 25, the distribution and use of Fomepizole has been expanded not only in RSCM, but also in 17 hospitals in 11 provinces in Indonesia that have received Fomepizole distribution.

Around 87% of Fomepizole imported by the Ministry of Health from abroad are free donations from friendly countries.

Previously, the Ministry of Health had also issued Instructions for the Use of Liquid/Syrup Drugs in Children in the context of Preventing the Increase in Cases of Atypical Progressive Acute Kidney Disorders (GGAPA)/(Atypical Progressive Acute Kidney Injury) Number HK.02.02/III/3515/2022 dated 24 October 2022.

As of November 5, there have been 324 cases of GGAPA of which 102 have recovered, 194 died and 28 are still being treated.

This news was broadcast by the Bureau of Communications and Public Services, Ministry of Health of the Republic of Indonesia. For further information, please contact the Halo Ministry of Health hotline number via hotline 1500-567, SMS 081281562620, facsimile (021) 5223002, 52921669, and contact email address [at] Kemkes [dot] go [dot] id (NI).


https://www.kemkes.go.id/article/vie...bat-sirop.html

 

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No New Cases of Acute Kidney Disorder

Published On : Thursday, 17 November 2022 00:00:00, Read : 735 Times

Jakarta, 16 November 2022

Spokesperson for the Ministry of Health, M. Syahril, again updated data on the development of Acute Kidney Disease in Children (GGAPA). It was reported that in the last two weeks there were no new cases of GGAPA in Indonesia, death cases continued to decline.

So that until November 15, 2022, the number of GGAPA cases was recorded at 324, where there were no additional new cases since November 2, 2022, 111 patients recovered, with 199 deaths, while 14 cases were still being treated. Cases were dominated by children aged 1-5 years.

The 9 cases are currently undergoing treatment at RSCM, 2 patients in Aceh, 1 patient each in North Sumatra, West Sumatra and the Riau Islands. The patients treated were dominated by cases with a level of severity at stage 3. Those concerned were still being treated with the antidote Fomepizole.

''Stage 3 is the most severe, with severe kidney damage. Currently all patients are still being treated intensively in the Pediatric Intensive Care Unit (PICU). We are also trying to give Fomepizole, hopefully this will help," said dr. Syahril.

Of the fourteen patients, continued dr. Syahril reportedly did not have co-morbidities, but was purely GGAPA caused by EG and DEG toxicity in syrup/liquid medicine.

''So it takes time for the treatment process, we hope that all patients will improve soon,'' said dr. Syahril.

Dr. Syahril said, although there were still cases being treated, there were no new GGAPA patients in the last two weeks, from 2 to 15 November 2022. Patients being treated were patients who entered the hospital before 2 November and still needed treatment.

His party explained that the decrease in death cases and new cases was due to two things, namely the issuance of a Ministry of Health Circular Letter on October 18, 2022 which prohibited health workers and pharmacies from using syrup on children, until afifarma take down on October 31, 2022 and the use of the antidote fomepizole injection as part of therapy/medication to patients.

In order to prevent new cases and deaths, the latest policy adopted by the Ministry of Health is to issue Instructions for the Use of Liquid/Syrope Drugs in Children in the Context of Preventing an Increase in Cases of Atypical Progressive Acute Kidney Disease Number HK.02.02/III/3713/2022, which was stipulated in November 11, 2022.

Through this circular letter, all health facilities and electronic pharmacy system (PSEF) operators and drugstores in the use of drugs are asked to be guided by the explanation from the Head of BPOM regarding the list of drugs that may be used, excluded and may not be used.

''Outside of the existing list, it's best not to use it yet, wait for the results of further research,'' emphasized dr. Syahril.

In addition, the regulation also regulates 12 critical drugs that may be used but with the monitoring of health workers.

The twelve drugs include Valproic acid (Valproic acid), Depakene, Depval, Epifri, Ikalep, Sodium valproate, Valeptik, Vellepsy, Veronil, Revatio syrup, Sildenafil, Viagra syrup, Chloralhydrate (Chloral hydrate) syrup.

''These critical medicines can still be used by health workers with strict supervision,'' ordered dr. Syahril.

With the entry into force of this letter, the Plt. Director General of Health Services Number HK.02.02/III/3515/2022 dated 24 October 2022 and Letter Plt. Director General of Health Services Number HK.02.02/I/3565/2022 dated 28 October 2022, concerning Instructions for the Use of Liquid/Syrope Drugs in Children in the Context of Preventing an Increase in Cases of Atypical Progressive Acute Kidney Injury, revoked and declared not apply.

This news was broadcast by the Bureau of Communication and Public Services, Ministry of Health of the Republic of Indonesia. For further information, please contact the Halo Ministry of Health hotline number via hotline number 1500-567, SMS 081281562620, facsimile (021) 5223002, 52921669, and contact email address [at] ministry of health [dot] go [dot] id . (MF)

https://www.kemkes.go.id/article/view/22111700002/tidak-ada-kasus-baru-gangguan-ginjal-akut.html

 

[Shiloh]

Source: https://en.antaranews.com/news/2732...ilure-cases-in-w-java-may-be-measles-minister

Suspected kidney failure cases in W Java may be measles: minister
11 hours ago

Jakarta (ANTARA) - There is a possibility that suspected new cases of Atypical Progressive Acute Kidney Disorder (GGAPA) detected in children in West Java may turn out to be measles infections, Health Minister Budi Gunadi Sadikin has said.

"There are two cases undergoing an examination regarding the disease. We want to make sure if it is kidney failure or other diseases. The temporary indication shows an infection, it could be measles," he informed after the signing of a memorandum of understanding ( MoU) between the Ministry of Health and PT AstraZeneca Indonesia in Jakarta on Monday.

Sadikin confirmed that the two new suspected cases of acute kidney failure have been detected in West Java. One of the patients has been referred to Cipto Mangunkusumo Hospital (RSCM) in Jakarta for further treatment...