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Let’s stop calling it ‘Kawasaki-like’ syndrome(82 Posts)
- The name for the COVID-related illness hitting children is Paediatric Multisystem Inflammatory Syndrome (PMIS). Now that it’s recognised as a separate entity, we can discuss on its own terms.
- Research suggests that symptoms appear 12 weeks after initial infection, six weeks after recovery. So the uptick in cases now result from infection with Coronavirus in February/March
- Initially seemed to affect the under 5s; now it appears to be 5-18 year olds.
Up to last week, this was barely on our radar. Now it’s being increasingly reported. With the huge time lag between infection with Coronavirus and onset of MCIS, it seems wise to not simply dismiss Covid in children as ultimately benign (guilty of doing this myself).
I hope this is is somewhere we can discuss and share links. Will post some below.
So if I suspect (and only suspect) that I was symptomatic around March 21st but DC asymptomatic, that I should be keeping an eye around 14th June?
I think keeping an eye on children for a few months after seems sensible. Here’s what to look out for according to one LA hospital:
What is MIS-C?
MIS-C stands for multisystem inflammatory syndrome in children. Formerly called pediatric inflammatory multisystem syndrome, or PIMS, it describes a new health condition seen in children who have been infected with novel coronavirus, recovered from it and later have an immune response that results in significant levels of inflammation in organ systems and symptoms. MIS-C is similar to other inflammatory conditions like Kawasaki disease and toxic shock syndrome. Children who have MIS-C generally did not have obvious symptoms when they were infected with novel coronavirus, like cough, and generally were healthy prior to developing MIS-C.
Is MIS-C contagious?
No. MIS-C is not contagious. In order to have MIS-C, a child must have had the infection previously. It is believed that, for one to have the antibodies for COVID-19, a patient must be past the contagious stage of the disease.
Do you need to have another health condition to get MIS-C?
No. MIS-C does not appear to be limited to children who already have another chronic or significant illness that compromises their immune system.
If I think my child has MIS-C, what should I do?
If you think that your child has MIS-C, you should contact your child’s doctor or pediatrician immediately. Specialty hospitals like Children’s Hospital Los Angeles are sharing their findings with pediatricians in the community so that they know what to look for when screening patients. Families are likely to be able to obtain an initial screening quickly by contacting their pediatrician. At Children’s Hospital Los Angeles, a clinical team is devoted to finding out more information about MIS-C and is working to develop and release timely information to pediatricians who are members of the CHLA Health Network.
Families with a child experiencing serious illness should not delay in getting care and should immediately seek attention from their nearest emergency room.
What will my pediatrician ask me?
Your child’s doctor or pediatrician is likely to discuss several symptoms with you, and will be particularly alert to children who have experienced a high fever for four or more days combined with other symptoms that may include:
Abdominal pain without another explanation
Both eyes appearing pink or red
Enlarged lymph node (“gland”) on one side of the neck
Fever for seven or more days in an infant, for which no other explanation is identified
Red, cracked lips or red tongue that looks like a strawberry
Swollen hands and feet, which might also be red
My bad, the term seems to have been updated...
Are you a doctor, OP? You sound very knowledgeable on this subject. My child started with something very similar to what is being described in December. My child’s condition is called vasculitis. It was triggered by a virus. Is this post Covid 19 of the same family of illness as my child’s?
Even my very experienced older GP had only seen one other case of my DCs condition, but on our Facebook group we are seeing more cases come along. It seems to be an area not very funded or researched.
No unfortunately I’m not a doctor. Just keen to share what I’m reading about it. I hope your child is better.
Here’s a really useful Q & A about it from a New York paediatrician:
Some positive news on its (still) relative rarity and the fact that there are methods for treating it.
Just giving this a bump. It's a very scary thought and a good way to stop me slipping into complacency as this goes on and on.
This article about it in The Lancet (based on cases in Italy) says:
‘...a rare condition, probably affecting no more than 1-in-1000 children exposed to SARS-Cov-2.’
People have noted that this is roughly the same risk as encephalitis (inflammation of the brain) in measles. And the huge caseload is another problem. What seems negligible in 1000 cases becomes much more of an issue it’s 100,000 children who have been exposed, especially if otherwise healthy.
There is no need to call it Kawasaki-like - if you read up about Kawasaki disease, you'll see that one of the causative agents is coronavirus. Not THIS one specifically, but any coronavirus.
So since THIS specific coronavirus (SARS-CoV-2) is causing it, it's still Kawasaki disease, whatever they choose to rename it.
This is a good read for anyone worried. The UK kawasaki society are involved in tracking this.
You can note that on May 15th there were 230 child reported to have it, in world. And fewer cases have been reported in the UK this year. Not more.
Hi, can you advise what your source is for the three month lag between infection and presentation?
It's also worth noting that it is exceptionally rare. The symptoms however are something that parents should be aware of and keep an eye out for as they could likely be something else like sepsis/meningitis.
To put that in context 100 kids have been hospitalised with M-ICS whereas 25,000 kids are hospitalised with sepsis every year.
Surely anything that helps parents remember the signs/symptoms and raises awareness of Kawasaki Disease itself as well as the new Covid-19 related inflammatory condition is positive? Parents are not doctors but unfortunately people have a lot of time to pull apart wording at the moment. IMO all that matters is that parents know the signs and to seek urgent hospital treatment (and not delay due to Covid-19 fears).
Thank for the thread; if there's a lag of that length this is important info and data that needs to be tracked.
@blackcat86 I couldn't agree more. Its good that parents are being made aware, regardless of the pandemic.
Another saying thank you to OP for the information, and also to the PP for additional context.
Thanks, I've been keeping an eye on this and wasn't aware of the new name.
A difference has been identified as the age range?
Dr. Dermody said PMIS generally affects children from 1 to 2 years of age up to 15 and 16, “so it’s not a particular age range within pediatrics,” while Kawasaki disease predominantly affects toddlers.
I’ll try to find where I got that from... It was something like 6-12 weeks after exposure since we know Covid can have a long incubation period.
Thanks Redolent - for me there is a big difference between 6 weeks (our local peak for in-community was March, so that would mean that most cases of this would already have happened), and 12 weeks; which means that we haven’t started to see the impact of this yet.
Thanks Red and others. It helps to be aware.
I think 1/1000 sounds a lot but then we have more sepsis cases but then we haven't got huge numbers of the community got it.
If it is scaled proportionally ( eg for 80 percent of the population) how many cases are we taking? That would make me feel better about the risk.
I thought Kawasaki disease is called Kawasaki syndrome, a syndrome being the term for a collection of symptoms?
It also seemed to effect more African/Caribbean and Asian children in the first 8 children in the UK, i’m not sure if that is still the case? There was also an article in the guardian that it effects a certain blood compound:
On the NHS for Kawasaki it says
The children who develop Kawasaki disease may be genetically predisposed to it.
This means the genes they inherit from their parents may make them more likely to get the condition.
One theory is that rather than there being a single gene responsible for Kawasaki disease, it may be the result of many genes that each slightly increase the chances of a child developing the condition.
Kawasaki disease is more common in children from northeast Asia, especially Japan and Korea.
This also suggests there may be a genetic cause."
Wonder if it's similar with this too..
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