Indonesia sees acute kidney failure death toll in children rise

Pizaro Gozali Idrus
2022.10.21
Jakarta
Indonesia sees acute kidney failure death toll in children rise A sign in a Jakarta pharmacy notifies customers that the sale of some fever and cough syrups has been halted temporarily, Oct. 20, 2022.
Tatan Syuflana/AP

Thirty-four more children have died from acute kidney failure in Indonesia, according to figures announced by its health minister on Friday, a day after government officials ordered pharmacies to stop selling five medicinal syrups they say may be linked to the deaths.

Health Minister Budi Gunadi Sadikin said the actual number of illnesses could be five times higher.

“We have identified 241 (cases) in 22 provinces, with 133 fatalities,” Budi told reporters in Jakarta. On Wednesday, government officials announced a death toll of 99.  

The first two cases were reported in January, but the number has risen sharply since August. The health ministry recorded two cases in March, six in May, three in June, nine in July, 37 in August and 81 in September.

Budi said children between the ages of 1 and 5 were most affected and had symptoms including fever, loss of appetite and a low output of urine.

Children with acute kidney damage who were treated at Jakarta’s central Cipto Mangunkusumo Hospital (RSCM) were found to taken contaminated cough or fever syrups, Budi said.

“We tested the children and it turned out that from the children we tested at the RSCM, seven out of 11 children were found to have [ingested] harmful compounds called ethylene glycol and diethylene glycol,” he said.

The substances are sometimes used as a solubility enhancer in liquid medicines.

Health officials said there was no evidence the outbreak was linked to COVID-19 or its vaccines.

Budi said the government had identified and tested a drug that appears to be an effective antidote, Fomepizole, which will be imported in large quantities from Singapore.

“Of the six patients we have tested, four of them have responded positively,” Budi said.

‘She was never given a syrup’

Yusuf Maulana, a resident of Yogyakarta, said his 7-month-old daughter died in a hospital last month of acute kidney failure even though she was not given cough medicine.

“My daughter never took liquid medicine. But she suffered from fever, seizures and died of acute kidney failure,” Yusuf told BenarNews.

“She ate but urinated little. We thought that at that time her milk intake was low because at that time my wife had significantly reduced breast milk,” Yusuf said.

Dicky Budiman, an Indonesian epidemiologist at Griffith University in Australia, said acute kidney failure could be attributed to several causes, including malaria and dengue fever.

“Contaminated syrup is one of possible causes, but that doesn’t mean other things such as COVID-19 should be ruled out,” Budiman told BenarNews.

He also said the reported number of cases could be the tip of the iceberg, given a lack of early detection and poor health awareness in society.

On Thursday, the Food and Drug Monitoring Agency announced that five fever and cold syrups had been withdrawn from circulation, saying they contained levels of ethylene glycol and diethylene glycol that exceeded the safe threshold.

The government identified those medications as Termorex Syrup, Flurin DMP Syrup, Unibebi Cough Syrup, Unibebi Fever Syrup and Unibebi Fever Drops.

‘Extraordinary event’

Parliament Speaker Puan Maharani on Friday called for the government to declare the outbreak an “extraordinary event” to allow for more funding for treatment.

“This is likely the tip of the iceberg. There have been hundreds of cases, but the number of victims could be much higher. This is an emergency situation that threatens the safety of children,” she said. “Under the extraordinary event status, children diagnosed with acute kidney failure must receive treatment at no cost until they fully recover.”

Budi, on the other hand, said it was too early to declare the outbreak an extraordinary event.

“Based on our study, we are not at that stage yet,” he said.

Nazarudin Latif in Jakarta and Dandy Koswaraputra in Bogor, Indonesia, contributed to this report.

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