UF Health pediatrician gives guidance on new inflammatory syndrome in children

There is now another reason to pay even closer attention to a child’s fever. A temperature spike may be an indication of multisystem inflammatory syndrome in children, or MIS-C.

The syndrome, which may be linked to the novel coronavirus that causes COVID-19, was first identified in the United States in May. It often causes swelling in organs, including the lungs, kidneys and heart. Typically, children with MIS-C either had the virus or came into close contact with a coronavirus carrier, according to the Centers for Disease Control and Prevention.

Sonja A. Rasmussen, M.D., a professor in the UF College of Medicine’s departments of pediatrics and epidemiology, shares information about this rare but emerging condition.

Q: COVID-19 has caused mild illness in most children. So why has multisystem inflammatory syndrome in children become such a concern?

A: Doctors in Europe and the United States have identified children with a condition where different parts of the body, including the heart and other organs, become inflamed. We do not know what causes MIS-C, but we do know that many children with it have lab studies that suggest they either have COVID-19, had COVID-19 recently or had been in close contact with someone with COVID-19.

Q: What kinds of symptoms do children with this syndrome show and what kinds of therapies are being used to treat it?

A: Symptoms of MIS-C include fever, headache, abdominal pain, vomiting, diarrhea, rash, conjunctivitis (red eyes) and being more tired than usual. If your child has these symptoms, it is important to contact your child’s doctor. Some of these symptoms are similar to those seen in another condition called Kawasaki disease. For that reason, some children have been treated with medications that have previously been used to treat Kawasaki disease.

Q: MIS-C can sometimes mimic the symptoms of more common, less serious illnesses. What is the best course of action for parents who may be unsure about their child’s symptoms?

A: Some of the symptoms of MIS-C are similar to those that occur when a child has an illness due to a virus other than the one that causes COVID-19. Parents should contact their child’s doctor if they think their child might have MIS-C. The doctor can decide whether testing for MIS-C or for another cause is needed.

Q: Are there long-term health consequences of having MIS-C?

A: Since this is a new condition, we don’t know a lot about how it will affect children in the long term. We do know that some children have become severely ill with MIS-C, requiring admission to an intensive care unit, and a few have died.

Q: Not all children with the syndrome have tested positive for COVID-19. What does that suggest to you? Might there be a genetic factor or a delayed inflammatory response?

A: One possibility is that the test for COVID-19 might be wrong. No test is 100% accurate and that is true about the test for COVID-19. Some children with MIS-C who tested negative for COVID-19 using a test looking for the virus were found to be positive on a test for antibodies, suggesting that they had COVID-19 in the past. We don’t know why some children get MIS-C after COVID-19 and others don’t.

Q: What is the most important thing for parents to know about MIS-C?

A: It appears that this illness might be linked to COVID-19, but based on what we know now it is a rare complication. It is important for parents to avoid becoming infected with COVID-19 for their own health and to prevent their child from becoming infected. To do this, you and your family should do the following:

• Physically distance from people outside your family (maintain at least a 6-foot distance)
• Wash hands frequently with soap and water for at least 20 seconds. If soap and water are not available, a hand sanitizer can be used.
• Wear a mask when you are out in public — your child should also wear a mask if he or she is 2 years old or older.