SELAMAT DATANG Dr. JEFRI SITORUS, M.Kes semoga sukses memimpin KKP Kelas I Medan------------------------ Kami Mengabdikan diri Bagi Nusa dan Bangsa untuk memutus mata rantai penularan penyakit Antar Negara di Pintu Masuk Negara (Pelabuhan Laut, Bandar Udara dan Pos Lintas Batas Darat=PLBD) ------

Disease Outbreak News

Saturday, June 7, 2008

Pakar Kesehatan Terkemuka Dunia Desak Semua Negara Gunakan Data Baru

ISTANBUL, 5 Juni (ANTARA/PRNewswire-AsiaNet) -- Lebih dari 350 pakar ilmiah terkemuka dunia, pembuat kebijakan dan profesional bidang kesehatan masyarakat terkemuka dari 67 negara hari ini bertemu pada Simposium Rotavirus Internasional ke-8 di Istanbul, Turki, untuk memaparkan data baru tentang rotavirus -- penyakit yang menyebabkan diare akut dan seringkali mengakibatkan kematian di antara anak-anak kecil. Selengkapnya

Friday, June 6, 2008

Depkes Gelar Kampanye Pengendalian Infeksi di Rumah Sakit

Depkes OL, 04 Jun 2008

Untuk menjamin keamanan dan keselamatan pasien di rumah sakit, Departemen Kesehatan RI bekerja sama dengan PT MRK Diagnostic meluncurkan program NICE (No Infektion Campaign and Education) sekaligus menyelenggarakan seminar yang diikuti sekitar 150 orang dari utusan Depkes, berbagai rumah sakit dan laboratorium klinik di Jakarta. Program ini dirancang untuk mengubah perilaku petugas kesehatan di 100 rumah sakit selama Juni 2008 – Oktober 2009. Peluncuran dan seminar dibuka oleh dr. Farid W. Husain, Dirjen Bina Pelayanan Medik Depkes di Jakarta, 4 Juni 2008.

Dalam sambutannya Dr. Farid W. Husain, menyatakan Departemen Kesehatan telah memiliki program “Patient Safety”. Salah satu pilar menuju patient safety adalah merevitalisasi program pencegahan dan pengendalian Infeksi di RS (PPI RS). Melalui program ini, diharapkan infeksi nosokomial (infeksi yang didapat dan atau timbul pada waktu pasien dirawat di rumah sakit) dapat ditekan serendah mungkin, sehingga masyarakat dapat menerima pelayanan kesehatan secara optimal.
Menurut dr. Farid Husain, infeksi di rumah sakit (sekarang Health-care Associated Infection = HAIs), merupakan persoalan serius yang menjadi penyebab langsung maupun tidak langsung kematian pasien. Walaupun beberapa kejadian infeksi nosokomial tidak menyebabkan kematian pasien, namun menyebabkan pasien dirawat lebih lama. Akibatnya pasien harus membayar lebih mahal, ujar Farid Husain.

dr. Farid W. Husain menyebutkan, pasien, petugas kesehatan, pengunjung dan penunggu pasien merupakan kelompok yang berisiko mendapatkan infeksi nosokomial. Infeksi nosokomial dapat terjadi melalui penularan dari pasien kepada petugas, dari pasien ke pasien yang lain, dari pasien kepada pengunjung atau keluarga maupun dari petugas kepada pasien. Saat ini infeksi nosokomial di rumah sakit mencapai 9% (variasi 3 – 21 %) atau lebih 1,4 juta pasien rawat inap di rumah sakit seluruh dunia.

“Infeksi rumah sakit terus meningkat (AI Varado 2000). Tingkat infeksi nosokomial berkisar dari 1% di beberapa negara Eropa dan Amerika sampai 40% di Asia, Amerika Latin dan Afrika Sub-Sahara (Lync dkk 1997)”, ujar dr. Farid Husain.

Menurut dr. Farid Husain, Departemen Kesehatan telah memiliki kebijakan nasional dengan diterbitkannya Keputusan Menteri Kesehatan No. 270/Menkes/III/2007 mengenai pedoman Manajerial PPI di rumah sakit dan Fasilitas Pelayanan Kesehatan lainnya dan Keputusan Menkes No. 381/Menkes/III/2007 mengenai Pedoman PPI di Rumah Sakit dan Fasilitas Pelayanan Kesehatan lainnya. Hal itu menunjukkan komitmen yang kuat dari pemerintah untuk memberikan pelayanan yang bermutu kepada masyarakat agar setiap rumah sakit dan fasilitas pelayanan kesehatan lainnya dapat menjalankan program pencegahan dan pengendalian infeksi.

Depkes juga telah menetapkan 5 rumah sakit sebagai pusat pelatihan regional pencegahan dan pengendalian infeksi yaitu RSUP H. Adam Malik Medan, RSUP Dr. Hasan Sadikin, Bandung, RSUP Dr. Sardjito, Yogyakarta, RSUD Dr. Soetomo, Surabaya, RSUP Sanglah, Denpasar. Selain itu, pencegahan dan pengendalian infeksi merupakan salah satu unsur dari Standar Pelayanan Minimum (SPM) yang selanjutnya akan dimasukkan dalam persyaratan akreditasi tingkat dasar enam pelayanan rumah sakit, tutur dr. Farid Husain.

dr. Farid Husain, menyambut baik program NICE yang bertujuan memberikan informasi dan kesadaran bagi seluruh staf di rumah sakit dan sarana pelayanan kesehatan lainnya mengenai bahaya dan risiko HAIs sekaligus untuk memperoleh data kejadian HAIs di rumah sakit.

Kampanye dan pelatihan NICE terselenggara berkat kerja sama Departemen Kesehatan dengan PT MRK Diagnostics dan GTZ (The Deutsche Gesellschaft fur Technische Zusammenarbeit). Program ini diselenggarakan sejak tahun 2007.

Berita ini disiarkan oleh Pusat Komunikasi Publik, Setjen Depkes. Untuk informasi lebih lanjut dapat menghubungi melalui telepon/faks: 021-52960661, atau e-mail puskom.depkes@gmail.com dan puskom.publik@yahoo.co.id.

Monday, June 2, 2008

Kasus AIDS : Sumut Peringkat 4



MEDAN - Provinsi Sumatera Utara berada di peringkat ke empat dalam daftar daerah yang memiliki jumlah kasus HIV/AIDS terbanyak di Indonesia setelah Papua, DKI Jakarta dan Jawa Timur. Hingga April 2008 tercatat sebanyak 1.238 penderita HIV/AIDS di Sumut terdiri dari 503 HIV dan 735 AIDS.

Demikian dikatakan Kadis Kesehatan Sumut Dr. Candra Syafei, SpOG ketika membuka Seminar Narkoba, Seks Bebas dan Hubungannya dengan HIV/AIDS yang diselenggarakan Forum Wartawan Kesehatan (Forwakes) di gedung Dharma Wanita Dinas Kesehatan Kota Medan, Sabtu (31/5).

Menurut Candra, jumlah penderita HIV/AIDS didominasi laki-laki berusia 20-30 tahun dengan faktor risiko penularan terdiri dari narkoba/jarum suntik, hubungan seks tidak aman dan berganti-ganti pasangan serta transfusi darah.

"Perkembangan HIV/AIDS ini bagai fenomena gunung es, dimana jumlah yang terdeteksi lebih kecil dibanding kasus yang sebenarnya. Pemerintah telah mengalokasikan anggaran sebesar Rp500 juta untuk pemberian obat secara gratis dan mensosialisasikan peningkatan kesadaran masyarakat untuk lebih peduli terhadap kesehatan," ujar Candra.

Sementara, Kadis Kesehatan Kota Medan Dr. Umar Zein, DTM&H, SpPD-KPTI yang tampil sebagai pembicara pertama pada seminar itu mengatakan, penularan HIV/AIDS tertinggi berasal dari pengguna narkotik suntik dan hubungan seks baik heteroseks maupun homoseks. Penularan HIV/AIDS melalui hubungan seks yang dilakukan dengan Wanita Pekerja Seks (WPS) mencapai 11 persen dan waria sebesar 33
persen.

"Berdasarkan estimasi, diperkirakan ada sekitar 11 ribu pengidap HIV/AIDS di Sumut. Penularan HIV/AIDS terbesar melalui penggunaan jarum suntik tidak steril di kalangan pecandu narkoba yang mencapai 60 persen. Setelah itu, penularan melalui hubungan seks, penularan dari ibu ke anak," ujarnya.

Tingginya kasus HIV/AIDS tersebut mendorong Dinas Kesehatan Kota Medan tetap mensosialisasikan penggunaan kondom, meski hal tersebut ditentang kalangan tokoh agama. "Kebanyakan mereka menganggap kami mendorong seks bebas, padahal yang kami lakukan bukan itu, tetapi mencegah agar penyebaran penyakit tersebut tidak semakin meluas. Kan kami tidak bisa menghentikan aktivitas seksual seseorang," tambah Umar Zein.

Sedangkan ahli kandungan RSU Dr Pirngadi Medan Dr. Christofel Tobing, SpOG(K) mengungkapkan sekitar 6 bayi telah tertular HIV/AIDS dari ibu yang melahirkannya. Sedangkan ibu tersebut telah tertular HIV/AIDS dari sang suami.

Saat ini, lanjut Christofel, dari 24.000 wanita yang mengandung di Indonesia, diperkirakan sekitar 30 persen berpotensi tertular HIV/AIDS dari sang suami yang suka "jajan" di luar. Dampaknya, bayi yang di dalam kandungan tersebut berpotensi tertular HIV/AIDS.

Sebelumnya, anggota Dewan Perwakilan Daerah (DPD) RI Parlindungan Purba,SH mengatakan, hasil survei di lapangan diperkirakan 6,5 juta wanita telah mengidap HIV/AIDS dengan faktor risiko prilaku seks bebas. Karenanya, diperlukan peran orangtua dalam keluarga untuk membimbing anak-anaknya yang telah beranjak remaja.

Menurut Parlindungan, para orangtua harus menjalin hubungan lebih dekat dengan anak-anaknya dan memberikan informasi tentang pendidikan seks. "Selain agama yang menjadi pondasi keluarga, komunikasi dan keakraban juga sangat dibutuhkan agar orangtua dapat mengawasi pergaulan anak-anaknya sehingga tidak terpengaruhi oleh informasi-informasi yang salah tentang seks," ujarnya.

Seminar yang diikuti kalangan pelajar dan mahasiswa itu juga dihadiri Direktur RSU Dr. Pirngadi Medan Dr. H. Sjahrial R. Anas, MHA, Kasubdin Pemberantasan dan Pencegahan Penyakit serta Penyehatan Lingkungan Dinas Kesehatan Sumut Dr. Surya Dharma, Kepala Seksi Pemberantasan Penyakit Menular Langsung Sukarni, SKM, Gubernur LIRA Sumut Drs. H. Halomoan Sitompul, MM dan lainnya.

DAVID SWAYANA WASPADA ONLINE
(ags)

http://www.waspada.co.id/Berita/Medan/Sumut-Peringkat-4-Kasus-AIDS.html

Study shows hybrids of bird flu and human flu viruses fit well, could occur

HELEN BRANSWELL, MEDICAL REPORTER

June 01, 2008 06:43

TORONTO - An experiment mating H5N1 avian flu viruses and a strain of human flu in a laboratory produced a surprising number of hybrid viruses that were biologically fit, a new study reveals.

And while none of the offspring viruses was as virulent as the original H5N1, about one in five were lethal to mice at low doses, showing they retained at least a portion of the power of their dangerous parent.

The work suggests that under the right circumstances - and no one is clear what all of those are - the two types of flu viruses could swap genes in a way that might allow the H5N1 virus to acquire the capacity to trigger a pandemic. That process is called reassortment.

"This study is just showing exactly that: There is a risk this virus can successfully reassort with a human virus," said Richard Webby, director of the World Health Organization's collaborating centre for influenza research at St. Jude Hospital in Memphis, Tenn.

"The problem is we don't know at this stage whether there's a benefit to these H5N1 viruses in doing that."

Nor can anyone say why, if the viruses swapped genes so readily in the laboratory, that hasn't seemed to have happened in the parts of the world where H5N1 has been circulating for years.

"This is the million dollar question," says senior author Dr. Ruben Donis, of the U.S. Centers for Disease Control's influenza division.

Reassortment is one of two ways in which a pandemic virus can evolve. The other is for a bird virus to acquire a number of mutations that allow it to more easily infect people and transmit among them.

The latter, called adaptive mutation, is thought to be the way the 1918 Spanish flu virus emerged. The viruses responsible for the milder pandemics of 1957 and 1968 arose through the mixing of human and avian flu virus genes.

This work, done at the CDC, was conducted to study the reassortment potential of H5N1 and H3N2 viruses. H3N2 is one of two human influenza A viruses that cause disease during flu season.

The study was published in PLoS Pathogens, one of the Public Library of Science journals.

Reassortment studies can be done one of two ways. One involves simultaneously infecting cells with the two viruses and seeing what nature produces. The other involves making viruses by piecing together combinations of synthesized human and avian genes.

"It's like Lego," Donis, head of the molecular virology and vaccines branch, says of this approach, which was the one used for this study.

But this is a game of Lego where it's not clear from looking at the pieces which will go together into a structure that will hold. "We really don't understand the rules of engagement for playing the Legos. We don't know what makes these things connect well or not connect well," he admits.

The researchers created 63 viruses representing the various potential combinations of human and avian internal genes, using an H5N1 virus that circulated in Thailand in 2004 and an H3N2 virus recovered in Wyoming in 2003.

All but one of the hybrids carried the hemagglutinin and neuraminidase genes - the H and N in a flu virus's name of H5N1. The remaining one used the neuraminidase from the human virus, creating an H5N2 virus that grew virtually as well as the H5N1 virus and was almost as lethal in mice.

Once the viruses were made they were placed in a medium to see if and how well they grew. Viruses were then harvested to use to infect mice, to test for virulence.

While 13 of the hybrid viruses either didn't grow or barely grew, the other 50 grew to some degree. And 28 replicated nearly as well as the original H5N1. Donis admits he was surprised by how well the avian and human gene combinations performed.

"I was expecting more incompatibility," he says.

By studying the combinations that succeeded and failed, the scientists were able to start to see patterns of which gene combinations are critical for an H5N1 virus to thrive.

When the most viable viruses were tested in mice, none was as nasty as H5N1. "That's the good news," Donis says, alluding to the fact that if reassortment turns H5N1 into a pandemic strain, the resulting virus could be less virulent than the current version.

Since late 2003 there have been 383 confirmed human cases of H5N1 infection and 241, or 63 per cent, of those people have died.

The virus that most closely matched H5N1 for virulence was one with three avian genes, the hemagglutinin and neuraminidase, plus the PB1 gene combined with five genes from the human virus.

Both the viruses from the 1957 and 1968 pandemics carried an avian PB1 gene. The authors suggest that picking up an avian PB1 gene may be a critical step in a potential pandemic virus arising through reassortment.

But just because the viruses mated successfully in a laboratory doesn't mean those viruses could go on to trigger a pandemic. In order to have that potential, a virus would have to be able to transmit from person to person - a skill that has so far eluded H5N1.

"The bottom line is it comes back down to transmission really being the key," Webby says. "But to say that we understand what are the factors involved in transmission is certainly an overstatement."

Earlier work at the CDC on some H5N1-H3N2 reassortant viruses showed they failed to transmit from infected to uninfected ferrets, an animal often used in flu research.

Donis says his team hopes to test its reassortant viruses in ferrets as well, but is still going through the approvals process.

News from ©The Canadian Press, 2008

Pandemic flu vaccine program needs help

Pandemic flu vaccine program needs help

By NED FEDER

June 01, 2008

A government document — never released — presents a troubling picture of a vaccine shortage during an influenza pandemic: Overall, about 2 percent of Americans with influenza illness die. Hospitals are overwhelmed. People riot at some vaccination clinics as they are turned away or supplies run out. Trucks transporting vaccine are hijacked. Public anxiety heightens mistrust of government. Mortuaries and funeral homes are overwhelmed. The majority of people still have not been vaccinated when a second wave of influenza begins.

These descriptions come from an October 2006 New York Times article by Gardiner Harris, who obtained the government document. The document was never released to the public as originally planned. Its portrayal of public chaos and a heightened mistrust of government is a reminder of past blunders — and this may have hit too close to home.

Are these scenes an accurate forecast of a disaster that lies ahead? Or, instead, will the federal government be ready with enough vaccine when a pandemic strikes? The government has announced its plans, and they are not reassuring. The official word is that it will be several years before government-funded vaccine manufacturers are fully ready to produce vaccine. Even then, there won’t be enough vaccine for everyone until six months after the start of a pandemic.

The government’s pandemic flu vaccine program is a fairly good one, with scientists who are among the best in vaccine research and production. But the program has an obvious and easily corrected weakness: lack of transparency.

The sheer quantity of information on the government’s pandemic flu Web site, www.pandemicflu.gov, with its hundreds of documents and thousands of pages, is impressive. But much important information is missing, raising the question: Why not disclose it?

There are striking gaps in the information posted online:

• The government’s multimillion-dollar contracts with vaccine manufacturers are not posted. The contracts should be out in the open, along with evaluations of contractors’ performance, updated periodically.

• Vaccine production is based on two methods: one using chicken eggs devised more than a half-century ago, and the other a cell-based method about a decade old. Promising new methods are just now being considered for the manufacture of vaccine — methods that can produce large amounts of vaccine quickly after the start of a pandemic. However, the government’s investment in these novel approaches may be too small and too slow. The timetable, budget and other plans for large-scale implementation of the new methods should be available online for examination and comment by nongovernment experts.

• When a pandemic strikes, foreign sources of materials needed for U.S. vaccine production will probably be blocked. If any part, even a small part, of the manufacturing process in the U.S. depends on foreign sources, this fact should be disclosed publicly, along with plans for full self-sufficiency of U.S. manufacturers.

• Some nongovernment experts have indicated that the pandemic flu vaccine program is dangerously underfunded. Detailed plans and justifications of future budgets should be posted online.

A recent Project on Government Oversight report, “Pandemic Flu: Lack of Leadership and Disclosure Plague Vaccine Program,” has a fuller discussion of the points raised above. The report — under the publication library link at www.pogo.org — also covers other information that should be disclosed online.

The argument is strong for posting more information. If public health and vaccine experts outside government have ready access, they can then examine the facts more easily and comment on current plans. The same is true for investigative reporters. The government’s goal should be the greatest possible transparency — disclosure of weaknesses along with strengths.

The nation’s top health official, Secretary of Health and Human Services Michael Leavitt, should make sure that the documents and information missing from the government’s pandemic flu Web site are posted — or explain why this information can’t be disclosed.

Ned Feder, staff scientist for the Project on Government Oversight, previously was a scientist at the National Institutes of Health.

Travel Notices - CDC Travelers' Health

MANTAN-MANTAN KEPALA KKP MEDAN