Canadian doctors tracking rare childhood illness associated with coronavirus

Canadian doctors are tracking a rare illness affecting children that could be associated with COVID-19.

The disease, called multisystem inflammatory syndrome or MIS-C, has been reported among children in the United Kingdom, Italy, France, and the United States.

“It’s an inflammatory auto-immune response,” says Dr. Stephen Freedman, professor of pediatrics and emergency medicine at the University of Calgary. Freedman is currently heading a global study looking at COVID-19 infections in children. He says MIS-C is usually not contagious because by the time a child presents with the syndrome, they are presumably no longer harbouring the virus.

“It’s the anti-bodies and immune system that have been triggered by the virus that is now causing the symptoms in the child,” he says.

“It’s not very clear what the links are between COVID-19 and this syndrome,” said Soumya Swaminathan, Chief Scientist at the World Health Organization. “There are some children who tested positive for the virus and some who haven’t.”

Doctors around the globe are still attempting to come up with a clear case definition. Symptoms currently associated with the illness include persistent fever, rash, red eyes, nausea, and diarrhea. It is similar to what physicians typically identify as Kawasaki disease.

Dr. Freedman says so far in Canada there have been very few cases as severe as what has been reported in the United States.

“We don’t actually have a lot of children who fit this definition. Although now that we are much more aware of it, we’re starting to look back and say, ‘do we have children who we diagnosed with Kawasaki disease who may have fit this criteria as well.'”

He says the trend in other regions suggests that cases of the illness tend to follow the peak of COVID-19 infections by about four weeks.

Ontario hit its peak at the end of April. Doctors in the province expect they will see more cases of MIS-C soon.

“We haven’t seen the severe, really unusual type of Kawasaki disease or inflammatory syndrome that’s being described elsewhere,” said Dr. Jeremy Friedman, Associate Pediatrician-in-Chief at Sick Kids Hospital in Toronto. He notes a slight increase of five cases of Kawasaki disease last week compared to an average of two a week. He adds that the vast majority of cases respond well to treatment.

“I think it is possible in the next week or two that we will see a few cases. As long as I think we are on alert for it and we’re keeping a close eye open for it, even if there are some cases, I would be pretty confident that that would be quite manageable.”

Ontario Minister of Health, Christine Elliott, announced on Wednesday that the province is actively monitoring cases of the illness.

Doctors are encouraging parents who feel their child may have the syndrome to seek medical help or bring their child into their local emergency department.