Some children’s hospitals see another increase in rare complication of Covid-19 MIS-C

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The U.S. Centers for Disease Control and Prevention said Thursday it had seen a 12% increase in reports of multisystem inflammatory syndrome in children, or MIS-C, since late August. Doctors at a handful of children’s hospitals across the country say they are still treating more cases of MIS-C than they were at the start of the year, even though MIS-C is considered rare.

“We had a long hiatus with these cases over the summer and even fall where we could get an occasional MIS-C case here and there, but in the last three or four weeks there has been a slight increase. And I expect that to continue over the next few weeks, “said Dr Amy Edwards, infectious disease specialist at UH Rainbow Babies & Children’s Hospital in Cleveland.

The CDC said it was aware of 5,217 cases reported through October 4. At least 46 children have died from MIS-C – a more than 12% increase in deaths from the previous month and one of the largest increases this year.

Overall, children are much less likely than adults to be hospitalized or die from Covid-19. More than 5.9 million children have been diagnosed with Covid-19, but MIS-C cases represent only a tiny fraction – well less than 1% – of all identified cases in children.

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Doctors are not sure what causes MIS-C. Often, children have Covid-19 first, but not always. For the few children who develop MIS-C, the disease seems to inflame different parts of the body, and it can be serious.

The CDC advises parents or caregivers to contact a doctor immediately if a child has fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or additional fatigue. .

At Children’s National in DC, the rise in cases just started last week, according to Dr. Roberta DeBiasi, chief of the pediatric disease division. This wave of new MIS-C cases was not as large as two outbreaks earlier in the year when they saw up to 60 MIS-C patients. For this wave, they have had around 18 MIS-C patients so far.

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At Colorado Children’s Hospital, they also saw “considerably” more cases of MIS-C in September, compared to previous months, according to Dr. Sam Dominguez, a pediatric disease expert at the hospital. But he said they weren’t seeing the same rates as in December 2020 and January 2021.

Children’s Healthcare of Atlanta also noted an increase in MIS-C cases in late September, about nine weeks after the region saw a spike in cases.

Over the past four weeks, Children’s Healthcare of Atlanta has treated 58 children with MIS-C – nearly 20% of all cases of MIS-C they have treated so far – but Jennifer Burkhardt, spokesperson from the hospital, said that MIS-C is still considered rare. This happened in less than 5% of the nearly 7,400 children they treated for Covid-19.

Burkhardt said that to prevent MIS-C and Covid-19, the hospital strongly recommends that all eligible people get the vaccine. Georgia’s vaccination rate lags far behind the rest of the country. While over 56% of the US population is fully vaccinated, according to the CDC, only 48% of Georgia’s eligible population has been fully vaccinated and only 46% of Georgian adolescents have been, according to the Department of Health. from Georgia.

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The rise in the number of cases has not had a uniform impact on the country. Regions with lower peaks of Covid-19 cases, such as Chicago, are not reporting increases in MIS-C, according to Dr. Bill Muller, infectious disease specialist at Ann & Robert H. Lurie Children’s Hospital from Chicago. “We have seen an increase in Covid-19 cases with Delta, including an increase in hospitalizations, but it was not at all close to what the South had,” Muller said.

Doctors say this is why vaccines are so important, even though small children are not eligible to receive a vaccine. The adults around them who can help reduce the number of cases in the community. If the number of Covid-19 cases is lower, children are much less likely to develop MIS-C.

Children who appear to be the most vulnerable to MIS-C appear to share similar demographic characteristics. Most of the reported cases of MIS-C have been in children and adolescents between the ages of 5 and 13, with an average age of around 9, according to the CDC. More than half, 59%, were men. MIS-C has disproportionately affected children of color. In its latest update, the CDC said 61% of reported cases were in Latino or non-Hispanic black children.

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Edwards of the UH Rainbow Babies & Children’s Hospital in Cleveland said many of the children they treated for MIS-C first had mild or even asymptomatic coronavirus infections. She said it was something parents should keep in mind.

“Even if you don’t know if your child has had Covid, if he has had mild symptoms after being exposed to someone, but then he got better and about a month later he seems to be getting sick again, especially if he has a really high fever I would be wrong in getting them checked out ASAP, “Edwards said.” What we know about MIS-C is that the earlier you intervene, the less the children seem to be sick. “

DeBiasi of Children’s National said he has had great success in treating patients with MIS-C. Treatment includes fluids, respiratory support, anti-inflammatory drugs, and immunoglobulin infusion. “Even the sickest children with MIS-C who are in the intensive care unit and need a lot of support, really seem to recover relatively quickly once they start immunoglobulin quickly,” said DeBiasi.

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