30 LONGISLANDPRESS.COM • JUNE 2020
QUESTIONS SURROUND NEW COVID-19 PEDIATRIC SYNDROME
Is this mystery illness Kawasaki
disease? This is not Kawasaki disease.
Multisystem Inflammatory Syndrome
in Children (MIS-C) shares a lot of similarities
to Kawasaki but also several
differences, which is what we are seeing.
When we look at both of them — the reason
people are saying it’s Kawasaki-like
is because of these similarities. However,
with MIS-C, we are seeing the following:
Conjunctivitis (red eyes) without discharge;
red, cracked lips and a strawberry
tongue; rash to the body; and swelling and
peeling of the hands and feet.
What are the similarities between
MIS-C and Kawasaki disease? Both tend
to have high fevers for several days, sometimes
more than a week. What’s different
is, most kids with MIS-C present with GI
symptoms — severe abdominal pain,
vomiting, and a lot of diarrhea. Also, we’re
seeing this predominantly in school-age
children (5 to 15 years), whereas Kawasaki
typically affects kids under the age of 5.
Although we see this condition in all ages,
the majority is at the ages of 5 to 15. What
is concerning about both is that they lead
to inflammation of blood vessels and
the heart, which, if untreated, can cause
serious long-standing problems, which
is why it is so important to diagnose the
symptoms.
Is it connected to COVID-19? There
definitely seems to be a link at this point
in time. Most of these cases seem to
occur approximately one month after a
geographic area has seen a spike in adult
COVID cases. There is a thought that this
is a post infectious reaction to COVID
in children. Most children have tested
positive for either the virus via a nose or
stool swab, or have evidence of antibodies
in their blood. Further research will need
to be done to show if it’s a direct result of
infection.
When is this a phone conversation with
your pediatrician or an emergency
room visit? Because we are still learning
about this, I think any time a child has
a fever, they should reach out to their
pediatrician. Fever alone does not mean
they have MIS-C, but when it’s a prolonged
fever with the other signs and symptoms
that we discussed, it makes it more concerning.
A pediatrician can help guide
parents as to when to seek in-person care,
which may involve an examination and
some laboratory work. Children should
be seen emergently if parents notice any
signs of respiratory distress, are showing
signs of dehydration, including increased
sleepiness or weakness, or they aren’t
making tears or urine. They should also
be concerned if they have severe abdominal
pain, as this may be a sign of MIS-C or
other surgical problems like appendicitis.
Is there any way to avoid MIS-C? If
we work off the assumption that this is
related to COVID infection, the best way
to avoid this is the same as trying to avoid
an actual COVID infection. Social distancing,
masking for kids older than 2 when
out in public spaces, and plenty of hand
washing is our best bet. It is important
to understand that although many kids
have already probably been infected
with COVID, an overwhelming majority
of them will not develop MIS-C, and will
recover just like they would from any
other viral infection they may have had
in the past.
Is multisystem inflammatory syndrome
treatable? Speaking of recovery,
an overwhelming majority of children
who have been diagnosed with MIS-C
make a full recovery. MIS-C, does seem
to be responding to the same medications
we give to children with Kawasaki’s
disease. Intravenous immunoglobulin
(IVIG), steroids, and aspirin are being
administered, and we are seeing symptoms
completely resolve in a day or two.
Of course, timely diagnosis and treatment
is key — all the more reason to be
in contact with your pediatrician should
they get sick.
"Timely diagnosis and treatment is key,"
says Dr. Christopher Kelly.
PRESS HEALTH
continued from page 29
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