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MIS-C: What you need to know

The province is seeing a rare multisystem inflammatory syndrome, called MIS-C, in reaction to COVID-19 in children. Here’s the latest on how to recognize the syndrome from BC Children’s Hospital specialists.
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​BC Children’s Hospital has seen a small number of children with confirmed MIS-C and physicians are monitoring the situation closely.

“It’s an immune response that happens in the body in a small portion of children” says Dr. Kevin Harris, a pediatric cardiologist at BC Children’s.

MIS-C is a newly recognized syndrome being reported in children and adolescents, linked to the COVID-19 virus. 

“It’s not something parents need to worry they’re going to miss it,” says Harris. “It’s a case where the child would appear very sick and parents would be bringing their child in to the doctor for evaluation. It’s up to us, as medical teams to make sure it’s on our radar as something we need to evaluate for and treat.”

Symptoms of MIS-C may include: 

  • persistent fever  
  • stomach pain and vomiting/diarrhea
  • rash or redness in fingers or toes
  • shortness of breath/or breathing problems
  • conjunctivitis
  • or swollen lips, hands or feet

“It’s a syndrome where the symptoms overlap with other types of conditions so the common symptoms you’d see in this are things like a prolonged fever, but it’s associated with things like stomach pain, vomiting, diarrhea, often a rash. Sometimes there can be swelling of the lips hands or feet and redness of the eyes. Some children will get more severe symptoms like shortness of breath. Because it’s a constellation of symptoms, it’s up to doctors to recognize it, and to determine whether the symptoms are related to a previous COVID-19 infection or a different cause.”

MIS-C symptoms are similar to other inflammatory or infectious conditions, such as Kawasaki disease or toxic shock syndrome, and can be mistaken for appendicitis. While MIS-C shares similarities to other inflammatory syndromes of childhood, some clinical features tend to be prominent, such as heart and gastrointestinal inflammation.

MIS-C first surfaced internationally

The first reports of MIS-C were seen in April 2020. North America, Europe, India and Africa have all identified children with MIS-C. It appears to lead to severe widespread inflammation in different parts of the body, including the heart, gastrointestinal system, lungs, kidneys, brain, skin, eyes, and lymph nodes.

It can be serious and even deadly, but most children get better with medical care. The province has seen much lower rates of COVID-19 infection than harder-hit areas of the world so we expect to see fewer cases of MIS-C in our province. 

“This is a very rare condition so far in B.C. and even amongst those with COVID-19,” says Harris. “To date in B.C., there have been more than a thousand children with COVID-19 and we’ve reported a small number of cases of MIS-C to BC Public Health.”
COVID-19 has a low infection rate in children 

The number of children hospitalized for COVID-19 is very low, at about two per cent of cases. No children have died due to COVID-19 in B.C. 

All possible cases of MIS-C are reported to public health to ensure they are fully investigated. 

To be confirmed, patients must test positive for the COVID-19 virus, test positive for COVID-19 antibodies, or have a known exposure to another person with COVID-19.  

MIS-C is believed to occur after a COVID-19 infection. Studies have shown a two- to six-week lag between cases of COVID-19 and cases of MIS-C. While tests for active COVID-19 infection are usually negative at the time that MIS-C develops, almost all cases of MIS-C around the world test positive for antibodies to COVID-19, indicating the previous exposure. In B.C., antibody testing is limited to specific clinical and research uses, including patients being investigated for MIS-C.

Working with national and international partners

Specialists at BC Children’s are available to assess and provide advice for children possibly affected by this condition. We are working with provincial partners to ensure that information can be rapidly disseminated across B.C. for the benefit of all children in the province. We are also part of national and international working groups dedicated to MIS-C.

“The good news is,” say Harris, “for most children with MIS-C, even those who are severely affected, they go on to recover from it – and many recover completely before they even leave the hospital.”

For more information on MIS-C, please see the BCCDC website.

BC Children's Hospital; COVID-19; MIS-C
Children's Health
SOURCE: MIS-C: What you need to know ( )
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