After months of arguing that children could be saved from serious coronavirus complications, the highest county public health officials are warning against a rare inflammatory disease that is appearing among some children and that would be related to the virus.
Specialists say the disease is similar to Kawasaki disease, a rare inflammatory condition of unknown origin that affects children under the age of 5; as well as toxic shock syndrome, another rare condition that occurs when certain types of bacteria in the body produce toxins.
The disease, called pediatric multisystemic inflammatory syndrome (MIS-C), has mainly occurred in children in New York, the epicenter of covid-19 in the country.
But a case of Kawasaki disease diagnosed in a Plano boy this month, as well as several cases at Cook Children’s Hospital in Fort Worth, have left some fear that the disease has reached Texas and what it could mean for children. who have been infected or have been exposed to the new coronavirus.
Here’s what you should know about MIS-C, explained by medical specialists and a North Texas mother whose son was diagnosed with a similar condition.
MIS-C can present with various symptoms, but generally consists of a persistent fever for four to five days, stomach pain, a rash, inflammation, and, in severe cases, organ malfunction and low blood pressure.
Doctors have referred to MIS-C as a “Kawasaki disease-like illness” because the symptoms are extremely similar.
The main difference is that Kawasaki disease only affects children of no more than 5 years old, while MIS-C can affect even adolescents.
The CDC says that MIS-C can affect anyone up to the age of 21 who experiences fever, inflammation, and severe decompensation that affects at least two organs and requires hospitalization.
Furthermore, the patient must have recently tested positive for covid-19 or had covid-19 antibodies or been exposed to the virus within four weeks of showing symptoms.
Other symptoms may include confusion, red or pink eyes, cough, diarrhea, headache, swollen lymph nodes or neck swelling, breathing problems, sore throat, red or swollen feet and hands, fainting, vomiting, swelling of the lips or tongue, and joint pain, according to the New York City Department of Health.
Britney Boler said her 3-year-old son, Titus Foot, had many of the symptoms of Kawasaki disease and MIS-C before he was diagnosed with Kawasaki disease.
He says he went to Children’s Medical Center Plano three times until doctors diagnosed him with Kawasaki disease.
She reported that she became ill on April 27, and she assumed it was a simple cold; but the next day she took him to an emergency room when the fever rose to 101 degrees and she thought she might have covid-19.
Doctors checked Titus for tonsillitis, but when the test came back negative, they told Boler that the boy likely had a viral infection and returned them home.
The next day, he began to worry when his fever increased again and his son began to complain of pain in his stomach.
He took him back to Children’s, where doctors did more tests and told him that his son had a urinary tract infection and prescribed antibiotics.
But they were just about to leave the emergency room, the fever increased again, and this time to more than 103 degrees.
Doctors gave Titus medicine to lower his fever until it subsided, and Boler took his son home.
“The first two times I knew something was wrong,” he said. “But you know, I’m not a doctor; I thought if I needed to go back, I could go back.”
On her third visit to the emergency room, four days after the first time she brought her son, doctors diagnosed her with Kawasaki disease.
Dr. Jeffrey Kahn, director of infectious diseases at Children’s Health and a professor at UT Southwestern, said Kawasaki disease is sometimes difficult to diagnose.
Although he could not comment specifically on the Titus case, he said that children have to meet certain criteria in order to diagnose Kawasaki disease, the first of which is having a fever for more than five days.
“You can imagine that if a child is going to have Kawasaki disease and have a fever on the first day or the second day, that alone does not meet the criteria,” he said, adding that other symptoms of Kawasaki disease may progress or appear during those five days.
Another thing that complicates the diagnosis is that there is no diagnostic test for the virus; The diagnosis of Kawasaki disease is based solely on clinical findings, Kahn said.
Specialists say that although MIS-C can cause serious complications in some children, it is generally treatable with a few days of hospital care, sometimes in the intensive care unit.
MIS-C is not contagious, so children cannot pass it on to the family or to other children.
Sick children generally receive intravenous immunoglobulin treatment – which gives the body a boost of antibodies – aspirin, and steroids.
“The good news is that, as with Kawasaki disease, almost all children are treatable,” said Dr. Charles Schleien, president of pediatrics at Northwell Health in New York, at USA Today.
“It is highly likely that with treatment the child will be well. It is not like fear of covid-19, for which we know that there is no treatment and it is a matter of luck.”
Boler says her son was admitted to the hospital’s intensive care unit within five minutes of his third visit.
Aside from his other symptoms, he says his blood pressure was low enough to require hospitalization.
“At that time, many lines crossed it,” he said.
Titus spent almost three days in intensive care until he was moved to another floor.
Her mother says she was released from the hospital on May 5.
How common is it?
The disease was originally recognized in the UK on April 26, according to the CDC.
Eight cases that occurred in that country, counting one death, were recently detailed in a study published in The Lancet.
Since then, MIS-C has been launched in several European countries and in New York, which is investigating more than 100 possible cases.
Three children have died of the syndrome in that state.
How is it related to covid-19?
Many of the children who had MIS-C have tested positive for covid-19.
Since inflammatory disorders are rare in children — Kawasaki disease, for example, occurs only in one in 10,000 children under the age of five in the United States each year — the presence of these concentrations suggests that there is a relationship between virus and disease, experts say.