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Doctors brace for rise in rare inflammatory illness in kids that may be linked to COVID-19

Last Updated Oct 17, 2020 at 7:27 am EDT

Little is known about a rare but serious inflammatory illness affecting kids that may be linked to COVID-19. It’s called MIS-C or multisystem inflammatory disease in children.

The condition first caught the attention of medical experts in the spring and researchers are still learning about the illness.

But with Ontario – and other provinces in Canada – now in a second wave of COVID-19, doctors are expecting to see more cases cropping up.

Dr. Rae Yeung, a professor of pediatrics and immunology at the University of Toronto and SickKids hospital, says that although the illness is relatively rare, parents should be aware of what to look out for.

“The cardinal feature is inflammation,” she says. “Inflammation is your body’s protective response to fight infection but sometimes it becomes over-active and this over-active immune system really manifests as fever. And fever is the critical feature that we see.”

Other symptoms of MIS-C include a vomiting, diarrhea, rash, red eyes, swelling and redness of the lips, tongue, hands, and feet. It is similar to Kawasaki disease or toxic shock syndrome but this illness appears to cause more inflammation. 

It’s still unclear what the connection is between MIS-C and COVID-19. According to Dr. Yeung, that’s because there is not one diagnostic test that can define MISC-C.

“MIS-C is really what we call a syndrome complex,” she explains. “So it’s the ability of an infection to trigger a hyperactive immune response in the body that really results in what we see as MIS-C. And the cardinal finding is really a prolonged and high fever, and inflammation of multiple different organ systems.”

Another reason why the illness is difficult to diagnose is because children who have suspected MIS-C don’t always test positive for COVID-19.

In some cases, MIS-C can develop up to four weeks after exposure to the virus meaning, even though the infection is gone, the body’s immune system may still be in overdrive.

Serological tests – which can detect whether a patient has previously been infected with COVID-19 – can help confirm the diagnosis, but that test has only recently become available in Ontario.

Researchers in Canada say the number of MIS-C cases in Canada is low.

So far, Ontario has four confirmed cases while BC has one. Quebec and Alberta have both reported potential cases of MIS-C.

The Centres for Disease Control and Prevention is reporting just over a thousand confirmed cases of MIS-C and 20 deaths in the U.S. That data also reveals that of the reported MIS-C cases, more than 70 per cent have occurred in children and adolescents who are Black or Hispanic.

In Canada, doctors have also detected a co-relation between ethnic background and the syndrome.

We do have some preliminary data,” says Dr. Yeung. “We can confirm that also in Ontario and in Canada in general it does appear to affect those from the Afro-Caribbean and South Asian communities a little bit more than the others.”

With children now back in school, there is heightened concern about their health especially because we are still in a pandemic.

Dr. Yeung shared some advice for parents. “Remember that COVID-19 is a mild illness in children and MIS-C is still very rare. When a child has prolonged fever, in this particular case 3-4 days or 5 days or more and the fever is unrelenting and you have the worrisome signs the child is ill then absolutely you should seek medical attention.” 

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