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Three pediatric patients in Indonesia died from acute hepatitis in April, the country’s health ministry said, boosting the global death toll from the mysterious liver ailment affecting children from the U.S. to Asia to at least four.

The children, hospitalized in the capital Jakarta, had symptoms including nausea, vomiting, heavy diarrhea, fever, jaundice, seizures and loss of consciousness, the ministry said in a statement Monday. It is urging parents to immediately bring children who exhibit these symptoms to the hospital.

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