Parents need to be aware of symptoms of rare COVID-19 condition in children

Meanwhile, families debating decisions
on summer camps, day care.

As doctors begin to understand the rare inflammatory condition related to COVID-19 in children, diagnosis is complicated because its symptoms mimic those of other viruses.

The serious health condition called Multi-System Inflammatory Syndrome in Children (MIS-C) shares some symptoms with Kawasaki disease – another rare childhood condition. But experts have determined it to be a different illness.

Symptoms linked to MIS-C include:

• Prolonged fever of more than 24 hours.
• Abdominal issues like diarrhea or vomiting.
• Headaches.
• Redness of the eyes.
• Rashes and changes in skin color.
• Trouble breathing.
• Confusion or being overly sleepy.

“If you’re noticing these types of symptoms in your child, contact your pediatrician or doctor to figure out the next step,” said Dr. Yungting Liao, associate medical director with John Muir Health & Stanford Children’s Health pediatric hospitalist services.

An emerging situation

First centered in Europe, MIS-C more recently appeared in New York City hospitals. No cases have been identified yet in the Bay Area, but Liao said some have appeared in the Los Angeles area.

Liao noted that sharing of information is essential for a better understanding of the nuances of this emerging condition.

Among the mysteries that physicians and researchers are wrestling with is how the condition is transferred or transmitted. Issues being examined include if MIS-C resulted from close contact with somebody else, if the condition is a post-virus response, or if the child had the virus a while back and is only now showing symptoms.

“We don’t exactly know,” Liao said.

Watch for symptoms

Her advice to parents is to take a back-to-basics approach with this new wrinkle in the COVID-19 era. If a child is having digestive problems, not eating or looks ill, contact your doctor or pediatrician and follow their instructions.

“This is a new disease that we are all learning about,” she said. “We are working with parents as this evolves.”

Dr. Tara Greenhow, regional lead of pediatric infectious diseases for Kaiser Permanente Northern California, voiced both a cautious and optimistic tone.

“The good news is the cases of MIS-C appear to be rare, and death is even rarer” when associated with symptoms related to COVID-19, she said.

Decisions about children’s activities

After doing the hard work of sheltering in place and practicing proper hygiene and social distancing to prevent the spread of COVID-19 the past few months, Greenhow acknowledged the period going forward will present new challenges for parents as they seek to maintain a balance between safety and their kids’ relationships with other youngsters.

Parents are weighing the emotional needs of their children as they consider summer camps in the current environment. Greenhow said there are guidelines put out for the camps, and parents can do their part by checking in with camps and asking questions to see that those guidelines are being followed.

“Many of us are having this conversation with our parents about what is happening,” said Greenhow. “That decision has to happen at the family level.”

Another heavy decision is whether to place the little ones back in day-care centers as those facilities reopen in the coming weeks and months.

“For some, it is a necessity for a parent to successfully return to work, but for others the decision is different. They may have other options available to them,” she said.

View the Centers for Disease Control’s camp information at cdc.gov/coronavirus/2019-ncov/community/schools-childcare/Camps-Decision-Tree.pdf. For more about MIS-C, visit the American Academy of Pediatrics at healthychildren.org.