State confirms six cases of rare syndrome in children

Six cases of a mysterious and potentially fatal syndrome in children with links to the coronavirus have appeared in Maryland, state health officials confirmed this week.

A 15-year-old Baltimore County girl died May 16 after showing symptoms of Multisystem Inflammatory Syndrome in Children, or MIS-C, an ailment that has been documented in children in New York and other locations, county officials said.

There have been no other deaths from the condition in Maryland, according to the state Department of Health.

Here’s what you need to know about the syndrome:

What is MIS-C? MIS-C is considered rare and is possibly linked to SARS-CoV-2, the virus that causes the COVID-19 illness. Some children believed to have MIS-C have tested positive for antibodies associated with the virus, though the connection is still unclear.

The Centers for Disease Control and Prevention reports that MIS-C has appeared in children as a persistent fever, low blood pressure and inflammation. Respiratory symptoms were not present in all cases, according to the CDC.

Medical experts from the Johns Hopkins Children’s Center say much of the information on MIS-C remains speculative in the absence of research.

“This is a newly recognized syndrome, which is severe but uncommon,” said Dr. Kwang Sik Kim, a pediatrician and Hopkins’ director for pediatric infectious diseases.

Medical experts have noted the syndrome mimics symptoms of Kawasaki disease, which tends to appear in children under the age of 5 as a fever, rash, reddened eyes, swollen tonsils and cracked lips, Kim said.

In comparison, cases of MIS-C differed by appearing in children over the age of 5 and including new symptoms not commonly associated with Kawasaki, such as shock or low blood pressure, Kim said.

When did MIS-C appear? In late April, clinicians in the United Kingdom identified several previously healthy children presenting a severe inflammatory syndrome with Kawasaki disease-like features, according to the CDC.

Those children also tested positive for current or recent infection by the coronavirus, the CDC said.

In early May, New York City health officials received reports of children with MIS-C, some of whom were admitted to intensive care units. New York City health officials have since identified more than 100 patients with symptoms of the syndrome.

Additional reports of children presenting a severe inflammatory syndrome with a link to COVID-19 have been reported by authorities in other countries, according to the CDC.

In Maryland, family members confirmed 15-year-old Dar’yana Dyson died May 16 at Johns Hopkins Hospital after showing symptoms of the syndrome.

State health officials say they have since identified additional cases and are monitoring the situation.

When should Marylanders seek medical attention? Kim recommends that parents monitor children who have been diagnosed with COVID-19 for at least four weeks, especially those over the age of 5.

“You just have to watch out if your child continues to have a fever and signs of inflammation,” Kim said. “Does the kid look sick compared to normal or complain about abdominal pain, and there’s a fever? I’d definitely seek a pediatrician to ask if these are signs of this syndrome.”

Experts are unsure if Multisystem Inflammatory Syndrome is specific to children or if it also occurs in adults. The CDC’s case definition for MIS-C includes individuals under the age of 21.