What parents need to know about COVID-linked inflammatory syndrome in children

Authorities in the United States are warning health care professionals and parents about a dangerous inflammatory condition appearing in children in recent weeks since the evolution of the coronavirus pandemic.

The CDC has confirmed that this vascular syndrome appears to be linked to COVID-19. Virtually all the children who have developed this condition have tested positive for a current or recent infection from SARS-CoV-2, the new coronavirus.

Doctors and public health officials in New York state, where dozens of cases have surfaced, have referred to the illness as pediatric multisystem inflammatory syndrome, or PMIS. However, the CDC has dubbed the illness multisystem inflammatory syndrome in children, or MIS-C, and issued what it refers to as a "case definition" for doctors around the country.

So what should parents know about this potentially fatal syndrome?

First, it very rare and it is treatable. Second, if you or someone in your household has had COVID-19, you should be on the lookout for certain signs and symptoms in your children so that you can act fast. 

The symptoms, which are similar to those of Kawasaki disease or toxic shock syndrome, may surface days to weeks after a child has a coronavirus infection.

These include prolonged fever, which means more than five days; difficulty feeding (for infants) or too sick to drink fluids; severe abdominal pain, diarrhea, and/or vomiting; change in skin color (such as becoming pale, patchy and/or blue); a rash over the body and limbs; swollen hands and feet, which might also be red; conjunctivitis (red or pink eyes); red, cracked lips or red, bumpy tongue that looks like a strawberry; trouble breathing or breathing very quickly; racing heart or chest pain; decreased amount or frequency in urine; and lethargy, irritability, or confusion, according to the New York state and New York City health departments.

"[B]ecause children with this syndrome may become seriously ill, it is important that parents know the signs and symptoms their children may have, so they can get help right away," the NYC Health Department states. "Call your child’s doctor immediately if your child has a persistent fever plus any of the above symptoms. The doctor will ask about the symptoms your child has and use that information to recommend next steps. If your child is severely ill, go to the nearest emergency room or call 911 immediately."

For a more detailed explanation of what doctors and public health officials know (so far) about multisystem inflammatory syndrome in children, you can refer to this "Fact Sheet" prepared by the NYC Department of Health and Mental Hygiene (you can scroll down to save a PDF version):

NYC Health Fact Sheet: Multisystem Inflammatory Syndrome in Children (MIS-C)

What is multisystem inflammatory syndrome in children?

Multisystem inflammatory syndrome in children (MIS-C) is a new health condition associated withCOVID-19 that is appearing in children in New York City (NYC) and elsewhere. The syndrome was previously called pediatric multisystem inflammatory syndrome or PMIS.

MIS-C is like other serious inflammatory conditions such as Kawasaki disease and toxic shock syndrome.

Children with MIS-C can have problems with their heart and other organs and need to receive medical care in a hospital.

MIS-C is a rare condition. However, because children with this syndrome may become seriously ill, it is important that parents know the signs and symptoms their children may have, so they can get help right away.

What are the signs and symptoms of MIS-C?

Most children have fever (temperature of 100.4 degrees F or 38.0 degrees C or greater) lasting several days, along with other symptoms.

Other common symptoms include:

• Irritability or decreased activity

• Abdominal pain without another explanation

• Diarrhea

• Vomiting

• Rash

• Conjunctivitis (red or pink eyes)

• Poor feeding

• Red, cracked lips or red, bumpy tongue that looks like a strawberry

• Swollen hands and feet, which might also be red

When should I call my child's doctor or get emergency care?

Call your child's doctor immediately if your child has a persistent fever plus any of the above symptoms.

The doctor will ask about the symptoms your child has and use that information to recommend next steps. If your child is severely ill, go to the nearest emergency room or call 911 immediately.

Is MIS-C contagious?

MIS-C is not contagious, but it is possible that your child has COVID-19 or another infection that may be contagious. This is why hospitals will take infection control measures when treating your child.

Is there a treatment for MIS-C?

Currently, children with MIS-C are being treated with different therapies, including medications targeted at the body's immune system and inflammatory response. Children may receive other medications to protect their heart, kidneys and other organs.

How can I prevent my child from getting MIS-C?

You should take steps to prevent your child from being exposed to COVID-19. Face coverings, hand hygiene and physical distancing are the best ways to prevent COVID-19. Children with underlying medical conditions can be at higher risk for poor outcomes of COVID-19, making prevention measures even more important.

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