Balai besar Laboratorium kesehatan
Resurgence of diphtheria in East Java
where do we are ?
Ismoedijanto
Balai besar Laboratorium
kesehatan
Surabaya, 09 10 2012
Propinsi versus kabupaten /kota
…………………….kecuali yang melakukan
ORI….
KKK (kemana kemkes kita)
…........
Hehehe….. Mohon maaf lahir
some view of a clinician
• Difteri sebagai penyakit menular (Clinical site)
– Gambaran klinik, komplikasi dan pengobatan
• Difteri as one of VPD (vaccine preventable
disease)
– Mencegah kesakitan, kematian dan komplikasi
– Imunisasi imunogen difteri
• difteri serve as one of the indices
– Indikator health services
– Indikator imunization services
Report and presentation on East Java
diphtheria
• Presentasi KLB difteri Bangkalan th 2005 di ACPID
(Asian Congress of Pediatric Infectious Disease) ke
3, Cebu Philipina
• Diramalkan menjadi klb pada PIT IDAI th 2007,
Yogyakarta
• Pertemuan imunisasi, SO Jawa Timur 2007
• Pertemuan SO ttg PD3I, Makassar 2008
mengingatkan difteri
• Laporan KLB diferi Jawa Timur di KONIKA /ACPID
4, 2008, di Surabaya
• Meeting TAGI 2008,2009, ( rekomendasi Td ) ,
Satgas Imunisasi IDAI 2009, 2010 , pertemuan
Kemkes selama th 2009, 2010 , (tidak ada tahun
WHO ELIMINATION GOAL FOR
DIPHTHERIA
“The target for European member states was the elimination of
indigenous diphtheria by the year 2000. This meant the
absence of indigenous cases caused by toxigenic
Corynebacterium diphtheriae strains.”
Ten years past the elimination target date and the elimination
goal has not been met.
Indigenous transmission continues: Latvia, Ukraine, Lithuania, Russian
Federation and other NIS countries. Sporadic cases: EU member states.
Cases and large epidemics are still occurring in other parts of the world,
South East Asia (Indonesia, India), Africa, Eastern Mediterranean,
South America.
EPIDEMIC DIPHTHERIA IS STILL WITH US
Clinical picture of
diphtheria
Gejala, tatacara diagnosis,
komplikasi
Gambaran klinik Diphtheria
• Masa Inkubasi 2-5 days (range, 1-10 days)
• Tanda utama
– Ada pseudomembran
– Menghasilkan toksin
•
site of infection
– Anterior nasal
– Tonsillar and pharyngeal
– Laryngeal
– Cutaneous
– Ocular
– Genital
MANIFESTASI KLINIK
• Variasi gejala: tanpa gejala hipertoksik & fatal
- Faktor-faktor:
- primer: imunitas, virulensi
- toksinogenesitas., lokasi anatomis
- lain-lain: umur, peny sistemik penyerta,
kepadatan hunian, peny pada nasofaring
• Masa tunas: 2-6 hari
• tanda klinik :
• Demam
where do we are ?
Ismoedijanto
Balai besar Laboratorium
kesehatan
Surabaya, 09 10 2012
Propinsi versus kabupaten /kota
…………………….kecuali yang melakukan
ORI….
KKK (kemana kemkes kita)
…........
Hehehe….. Mohon maaf lahir
some view of a clinician
• Difteri sebagai penyakit menular (Clinical site)
– Gambaran klinik, komplikasi dan pengobatan
• Difteri as one of VPD (vaccine preventable
disease)
– Mencegah kesakitan, kematian dan komplikasi
– Imunisasi imunogen difteri
• difteri serve as one of the indices
– Indikator health services
– Indikator imunization services
Report and presentation on East Java
diphtheria
• Presentasi KLB difteri Bangkalan th 2005 di ACPID
(Asian Congress of Pediatric Infectious Disease) ke
3, Cebu Philipina
• Diramalkan menjadi klb pada PIT IDAI th 2007,
Yogyakarta
• Pertemuan imunisasi, SO Jawa Timur 2007
• Pertemuan SO ttg PD3I, Makassar 2008
mengingatkan difteri
• Laporan KLB diferi Jawa Timur di KONIKA /ACPID
4, 2008, di Surabaya
• Meeting TAGI 2008,2009, ( rekomendasi Td ) ,
Satgas Imunisasi IDAI 2009, 2010 , pertemuan
Kemkes selama th 2009, 2010 , (tidak ada tahun
WHO ELIMINATION GOAL FOR
DIPHTHERIA
“The target for European member states was the elimination of
indigenous diphtheria by the year 2000. This meant the
absence of indigenous cases caused by toxigenic
Corynebacterium diphtheriae strains.”
Ten years past the elimination target date and the elimination
goal has not been met.
Indigenous transmission continues: Latvia, Ukraine, Lithuania, Russian
Federation and other NIS countries. Sporadic cases: EU member states.
Cases and large epidemics are still occurring in other parts of the world,
South East Asia (Indonesia, India), Africa, Eastern Mediterranean,
South America.
EPIDEMIC DIPHTHERIA IS STILL WITH US
Clinical picture of
diphtheria
Gejala, tatacara diagnosis,
komplikasi
Gambaran klinik Diphtheria
• Masa Inkubasi 2-5 days (range, 1-10 days)
• Tanda utama
– Ada pseudomembran
– Menghasilkan toksin
•
site of infection
– Anterior nasal
– Tonsillar and pharyngeal
– Laryngeal
– Cutaneous
– Ocular
– Genital
MANIFESTASI KLINIK
• Variasi gejala: tanpa gejala hipertoksik & fatal
- Faktor-faktor:
- primer: imunitas, virulensi
- toksinogenesitas., lokasi anatomis
- lain-lain: umur, peny sistemik penyerta,
kepadatan hunian, peny pada nasofaring
• Masa tunas: 2-6 hari
• tanda klinik :
• Demam