MIS-C linked to Covid-19, now in the Caribbean

Multisystem inflammatory syndrome in Children (MIS-C), a serious condition that appears to be linked to COVID-19, has reared its head in the Caribbean, and has resulted in the death of at least one child in Barbados. 

MIS-C, which has affected over 23 children in Trinidad and Tobago (T&T), appears to be an excessive immune response related to COVID-19/ the coronavirus disease. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 

Mayoclinic notes that the exact cause of MIS-C is not known, but many children with MIS-C have a positive antibody test result. This means they’ve had a recent COVID-19 infection. Some may have a current infection with the virus. 

Chief Medical Officer (CMO) Dr. Simone Keizer-Beache, commenting on the issue in an interview on Thursday March 18, said with MIS-C affecting the region’s children, it is now even more important for persons to get vaccinated against COVID-19. 

“MIS-C is associated with COVID-19 and a few weeks ago in Barbados, a child died from it.  

“It is thought that the children get infected with COVID-19, most of the times with an asymptomatic infection and sometime after they develop this MIS-C,” Keizer-Beache explained.  

According to Healthline, an online publication, a new model from researchers in Israel found that kids are half as susceptible to COVID-19 compared to adults. The report published Thursday, February 11, in PLOS Computational Biology also found that people under 20 are less likely to transmit the virus to other people. 

Keizer-Beache however noted that while children are half as susceptible to COVID-19 compared to adults, children can be seriously affected by MIS-C, so it is important to put things in place to protect them.  

“We normally vaccinate our children to protect them from measles, mumps, rubella and all those preventable vaccine diseases, and also by vaccinating children you protect the adults.  

“This situation with COVID-19 now, the children can’t get the vaccine as yet so to protect them we have to take the vaccines. The adults have to take the vaccine to protect the children and everybody else,” the CMO stressed.
 
It is not sure how many children in SVG have caught COVID-19 since it was first detected here in March 2020, but Keizer-Beache said we have seen cases in children under a year old but has so far not registered any cases of MIS-C.
 
According to the Centre for Disease Control (CDC) in the United States, as of October 1, 2020, the number of cases meeting the case definition for MIS-C in the United States surpassed 1000.  

As of February 1, 2021, this number surpassed 2,000. The CDC notes that many questions remain about why some children and adolescents develop MIS-C after a COVID-19 illness or contact with someone with COVID-19, while others do not. 

The CDC adds that most children who become infected with the COVID-19 virus have only a mild illness, but in children who go on to develop MIS-C, some organs and tissues, such as the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes, become severely inflamed. Signs and symptoms depend on which areas of the body are affected. 

“MIS-C is rare, and most children who have it eventually get better with medical care. But some kids rapidly get worse, to the point where their lives are at risk,” the CDC notes while adding that rarely, some adults develop signs and symptoms similar to MIS-C, called multisystem inflammatory syndrome in adults (MIS-A).  

Signs and symptoms of MIS-C include (though not all children have the same symptoms), fever that lasts 24 hours or longer, vomiting, diarrhea, pain in the stomach, skin rash, feeling unusually tired, fast heartbeat, rapid breathing, red eyes, redness or swelling of the lips and tongue, redness or swelling of the hands or feet, headache, dizziness or lightheadedness and enlarged lymph nodes. 

“Much remains to be learned about this emerging inflammatory syndrome. If your child shows any signs or symptoms, get help fast,” the CDC stresses. 

It is also noted that emergency warning signs of MIS-C include severe stomach pain, difficulty breathing, bluish lips or face, new confusion and inability to wake up or stay awake. 

“If your child has any of the emergency warning…or is severely sick with other signs and symptoms. get care immediately.

Take your child to the nearest emergency department. 

“If your child isn’t severely ill but shows other signs or symptoms of MIS-C, contact your child’s doctor right away for advice,” the CDC advises while noting that most children with MIS-C are between the ages of three and 12 years old, with an average age of eight years old and some cases have also occurred in older children and in babies. 

Many specialists consider MIS-C to be a complication of COVID-19. Without early diagnosis and appropriate management and treatment, MIS-C can lead to severe problems with vital organs, such as the heart, lungs or kidneys. In rare cases, MIS-C could result in permanent damage or even death. 

The CDC says that the best way to help prevent your child from getting MIS-C is to take action to avoid exposure to COVID-19  and with schools expected to open here on April 12, CMO Keizer-Beache is urging persons to not become complacent and to get vaccinated.  

 “You might say we shouldn’t open the schools until everybody is vaccinated. That would be what you might want to happen, however, until we get there we should really be focusing as much as possible on getting as many persons vaccinated.  

“We have to recognize that there is that risk of COVID-19 and that risk exists even without schools opening,” the CMO said while noting that MIS-C is difficult for children.  

“It is not an easy thing for a child and there is a child that died in Barbados from it.  

“Vincentians are too comfortable because they feel COVID is a mild thing, a flu, and it is not going to affect persons but we must realize that the same way a child can get COVID from a teacher or in a van going to school, a parent out there can also bring COVID home to that child,” the CMO stressed.