Answers for Parents About MIS-C, or Multisystem Inflammatory Syndrome in Children

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June 3, 2020


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This post is available in: Spanish

Public health officials have named it “multisystem inflammatory syndrome in children,” or MIS-C, a condition associated with COVID-19 that can run its course quickly and require hospitalization.

Although it remains rare, parents should be vigilant of common symptoms in their kids, and they should not hesitate to seek immediate medical care, says Fernando Mendoza, M.D., chief of pediatrics and medical director of pediatric emergency at Baptist Children’s Hospital.

While a few cases have been confirmed in South Florida, doctors in New York and other states have observed these symptoms as most pervasive over the past several weeks: fever, abdominal pain sometimes accompanied by vomiting, and sometimes a body rash and/or “pink eye” infection. A common factor appears to be prior exposure to COVID-19, but most children don’t show an active infection. The U.S. Centers for Disease Control and Prevention (CDC) has issued a health alert to physicians regarding MIS-C.

Most children respond to medical treatment, but MIS-C cases can become serious, and possibly fatal, because multiple body parts can become inflamed, including the heart, lungs, kidneys, brain, gastrointestinal tract, or skin.

“This disease is rare, but it is unpredictable,” emphasizes Dr. Mendoza. “Although most children end up doing fine, conditions can deteriorate rather quickly. So, don’t delay. At the very least, call your pediatrician. Or if you have any doubts, seek emergency pediatric care.”

Here’s more from Dr. Mendoza about MIS-C:

At this point, how much is known about MIS-C?
Dr. Mendoza:

It is still early in the life cycle of this disease. We’re still defining it. The important thing for parents to know is that this is a very rare syndrome. But if your child has a high fever, abdominal pain or vomiting, any kind of rash or any kind of eye infection — or any combination of these symptoms — you need to go see or call your pediatrician — or go to a pediatric emergency room right away. Most importantly, MIS-C affects the cardiac and vascular system. So, even though kids in general do get better, they may need some significant supportive care when it comes to medications to help support their blood pressure or their cardiac function.

Do we know why most children or young people with MIS-C have antibodies against the new coronavirus, rather than an active infection?
Dr. Mendoza:

We don’t know the exact cause, but we think that there is an antibody mediated response to COVID-19 that’s expressed later, after exposure or infection. From what we know, these kids don’t seem to be actively infected with coronavirus, but their antibody production has led them to have a response that’s very different from adults. There seems to be some association with a previous coronavirus infection or exposure in a household, but we don’t exactly know the cause.

Children with MIS-C appear to have been asymptomatic when infected with COVID-19. Are they more likely to spread the coronavirus in their households?
Dr. Mendoza:

Kids are less likely to be infected, and therefore less likely to be spreading asymptomatically than adults, but it can still happen. We know that at Baptist Children’s, and even regionally, that the positive conversion rate for kids who are tested with suspected COVID-19 is very low, less than 5 percent. That’s much lower than the conversion rate for adults. Initial data is coming out now that kids tend be the primary vector in the household for infection of coronavirus only about 8 percent of the time, whereas adults account for almost 80 percent of transmission source.

The CDC recently reported an alarming decrease in routine childhood vaccinations since the COVID-19 pandemic began. Why do parents need to know about this troubling trend?
Dr. Mendoza:

There’s a real concern that we’re going to see a resurgence of vaccine-preventable diseases in the near future. There was a distrust in the safety of going to the pediatrician to get your regularly scheduled vaccines, especially with the young children. But the risk of being exposed to COVID-19 is much less than the risk of getting one of these vaccine preventable diseases. Unfortunately, diseases like diphtheria, pertussis (whooping cough), tetanus can be serious. Pertussis has had some resurgence over the past few, and that can be a serious disease process that can actually be fatal in some kids, especially babies. Of course, measles is another huge one that can have many comorbidities (more than one disorder in the same person) associated with it.

What is your message to parents who may be hesitating, because of COVID-19, to take their child to their pediatrician or to a medical facility?
Dr. Mendoza:

We can’t let COVID-19 cloud over the judgment of when parents would normally seek ER care for any injury or illness that affects their children. A child’s well-being should not be delayed for fear of COVID-19 exposure in a pediatric ER. Be as alert as a parent normally would be. We’ll take care of them and we’ll take care of your health and safety when it comes to the coronavirus.

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