Multisystem Inflammatory Syndrome in Children (MIS-C): What Parents Should Know

Published on 
May 19, 2020

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From the beginning of the COVID-19 pandemic, children were a population left relatively untouched by the novel coronavirus. If infected, children often had few symptoms unless an underlying condition compromised their health. It was believed that children could have the disease without suffering from the symptoms.

If your child does become ill and maintains a high fever that lasts for several days, call your child’s doctor and seek medical attention immediately.

More recently, pediatric hospitals are sharing stories of children suffering from multisystem inflammatory syndrome in children, or MIS-C (formerly referred to as pediatric inflammatory multisystem syndrome, or (PIMS)). You may have heard of this referred to as Kawasaki disease, inflammation syndrome, severe inflammation from COVID-19 or something else. Though the information available about MIS-C is still extremely limited due to the small numbers of cases compared with the staggering numbers of people affected by COVID-19, pediatric specialists around the country, including those at Children’s Hospital Los Angeles, are focusing their efforts on determining whether more cases exist.

Children’s Hospital Los Angeles experts noticed an increase in the number of patients diagnosed with Kawasaki disease (a rare pediatric condition characterized by inflammation of blood vessels and abnormal dilations of the arteries supplying the heart with blood) in the month of April as compared to the previous two years. CHLA’s team began testing to determine whether the patients seen in recent months had antibodies demonstrating past COVID-19 infection. This began as hospitals in the United Kingdom and New York City started reporting children with significant inflammation, toxic shock syndrome and symptoms of Kawasaki disease following infection with the novel coronavirus.

By conducting serology testing for antibodies, Children’s Hospital Los Angeles has diagnosed three of its patients with MIS-C. Each child was initially believed to have Kawasaki disease and received treatment from the hospital’s team of experts in infectious diseases and Kawasaki disease. Positive antibody testing for each of the patients, combined with a set of symptoms consistent with other patients around the world and additional negative viral testing has led the CHLA team to diagnose these patients with MIS-C.  

Specialists in Cardiology and Infectious Diseases are now following up with additional patients who were recently diagnosed with Kawasaki disease at the beginning stages of the coronavirus pandemic to test them for antibodies of the virus causing COVID-19. Test results will help doctors carefully evaluate patients for MIS-C and supply them with more information to better understand the impact of the novel coronavirus on the pediatric population.

Children’s Hospital Los Angeles is a pioneer in treatment and research for Kawasaki disease and is committed to providing the best possible care for these patients as well as those suffering from toxic shock syndrome and MIS-C.

What is MIS-C?

MIS-C stands for multisystem inflammatory syndrome in children. Formerly called pediatric inflammatory multisystem syndrome, or PIMS, it describes a new health condition seen in children who have been infected with novel coronavirus, recovered from it and later have an immune response that results in significant levels of inflammation in organ systems and symptoms. MIS-C is similar to other inflammatory conditions like Kawasaki disease and toxic shock syndrome. Children who have MIS-C generally did not have obvious symptoms when they were infected with novel coronavirus, like cough, and generally were healthy prior to developing MIS-C.

Is MIS-C contagious?

No. MIS-C is not contagious. In order to have MIS-C, a child must have had the infection previously. It is believed that, for one to have the antibodies for COVID-19, a patient must be past the contagious stage of the disease.

Do you need to have another health condition to get MIS-C?

No. MIS-C does not appear to be limited to children who already have another chronic or significant illness that compromises their immune system.

If I think my child has MIS-C, what should I do?

If you think that your child has MIS-C, you should contact your child’s doctor or pediatrician immediately. Specialty hospitals like Children’s Hospital Los Angeles are sharing their findings with pediatricians in the community so that they know what to look for when screening patients. Families are likely to be able to obtain an initial screening quickly by contacting their pediatrician. At Children’s Hospital Los Angeles, a clinical team is devoted to finding out more information about MIS-C and is working to develop and release timely information to pediatricians who are members of the CHLA Health Network.

Families with a child experiencing serious illness should not delay in getting care and should immediately seek attention from their nearest emergency room.

What will my pediatrician ask me?

Your child’s doctor or pediatrician is likely to discuss several symptoms with you, and will be particularly alert to children who have experienced a high fever for four or more days combined with other symptoms that may include:

  • Abdominal pain without another explanation
  • Both eyes appearing pink or red
  • Enlarged lymph node (“gland”) on one side of the neck
  • Fever for seven or more days in an infant, for which no other explanation is identified
  • Red, cracked lips or red tongue that looks like a strawberry
  • Rash
  • Swollen hands and feet, which might also be red

What is the treatment for MIS-C at Children’s Hospital Los Angeles?

Currently, the treatment for MIS-C is a similar protocol to what is used to treat Kawasaki disease. The goal is to reduce the inflammation to avoid long-term damage to arteries in the child’s body and heart. This is accomplished through transfusions of plasma, which reduces the body’s own immune response that is causing the inflammation.

If my child was sick before (with a positive test or no test at all), but is OK now, should I still get my child checked by a doctor?

At this time, it is not recommended to do so. If your child does become ill and maintains a high fever that lasts for several days, call your child’s doctor and seek medical attention immediately. If your pediatrician believes that your child should have a serology (antibody) test following your screening, a referral can be made to a lab to have the test completed.

If you do not have access to a lab near you and you live in the Los Angeles area, you may visit one of our community blood draw and testing sites. Visit this link to find locations, hours and maps.

If my child was diagnosed with Kawasaki disease recently, should I contact my child’s providers?

Yes. It is likely that you have already been contacted for testing to validate whether your child has Kawasaki’s disease or MIS-C. At CHLA, Our goal is to test any patients who have been diagnosed with Kawasaki disease following the arrival of COVID-19 and developing a follow-up plan for each family.

How long will test results take?

Testing at community laboratory locations takes four to seven days. If at any time, while you are awaiting results, your child becomes ill or shows high fever over several days, please seek immediate medical attention at your nearest emergency room.