What is Multi-System Inflammatory Syndrome (MIS-C) and how to prevent it in children?

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<strong>A few days back there were widespread media reports about Delhi and the National Capital Region having registered about 177 cases of Multi-System Inflammatory Syndrome (MIS-C) in children following Covid-19 infection.</strong></p>
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The Capital reported 109 cases while 68 instances were recorded in Gurugram and Faridabad of MIS-C Syndrome post-Covid.</p>
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n MIS condition, a patient has fever and inflammation in multiple organs such as heart, lungs and brain. According to experts, fever, difficulty in breathing, stomach pain and bluish discolouration of skin and nails are signs of the disease.</p>
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Children between six months and 15 years are contracting this disease.</p>
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In a report by news18.com, Dr. Dhiren Gupta, Chairperson-elect of the Indian Academy of Paediatrics Intensive Care Chapter and paediatrician at Sir Ganga Ram Hospital said: “Acute infection of Covid-19 in children leads to two kinds of changes — a child may get pneumonia or there could be an antibody-mediated inflammation called MIS-C. Only prompt recognition can help catch the problem in time.”</p>
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The syndrome according to the experts is curable provided it is diagnosed early. In view of this syndrome, parents have been advised to be on guard for as much as one month after their own recovery period, as the syndrome has been found to be mostly treatable upon early diagnosis and intervention.</p>
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Talking about the news reports about a possible connection between Covid-19 and MIS-C, healthychildren.org states that scientists globally, including paediatric specialists, are working together to understand MIS-C and how best to diagnose and treat it.</p>
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While the link between Covid and MIS-C is not well understood, attempts are being made to understand if some children are more at risk.</p>
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The American Academy of Paediatrics, according to healthychildren.org wants to reassure parents that very few children get severely ill from the virus that causes Covid-19. So far, most children who have been diagnosed with MIS-C have recovered after getting medical care.</p>
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<strong>What is known so far?</strong></p>
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Those children afflicted by MIS-C have a fever and inflammation in their body. This gets confirmed by tests run at the laboratories. Some of the MIS-C symptoms have been the same as other childhood conditions like Kawasaki disease and toxic shock syndrome. MIS-C afflicted children may also have thrombosis (blood clots), poor heart function, or kidney injury.</p>
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<strong>MIS-C Symptoms</strong></p>
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Those children who have MIS-C are very ill with a fever for 24 hours or more. They have inflammation in their bodies and problems with many organs, such as the intestines, heart, brain, lungs, skin, and kidneys. It is advised that the child’s paediatrician be contacted immediately the moment the following symptoms are observed.</p>
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Fever (100.4 degrees Fahrenheit or higher) lasting 24 hours or more.</li>
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Abdominal pain, diarrhoea or vomiting.</li>
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Neck pain.</li>
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Rash or changes in skin colour.</li>
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Bloodshot eyes.</li>
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The child seeming extra tired.</li>
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Shortness of breath.</li>
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Pain or pressure in the chest which does not go away.</li>
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The child becoming confused.</li>
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The child is unable to wake up or stay awake.</li>
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The child showing bluish lips or face.</li>
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The paediatrician or the doctor in emergency should be told if the child has been tested positive for Covid or if he/she has been exposed to someone with the virus within the past four weeks.</p>
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<strong>Diagnosis and treatment</strong></p>
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Following are the tests that may be recommended by the doctors to help them diagnose MIS-C.</p>
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Blood and urine tests.</li>
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Chest x-ray, electrocardiogram, which measures electrical activity in the heart, and echocardiogram (heart ultrasound).</li>
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On the basis of the symptoms and the test results following treatment is suggested</p>
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Steroids to help treat swelling or inflammation.</li>
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Intravenous immune globulin (IVIG), a “biologic" medicine that contains immune-system antibodies.</li>
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Fluids given through a vein.</li>
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Heart medicines or low-dose aspirin.</li>
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Depending on the condition, some children may be hospitalised while others may need care in paediatric intensive care unit.</p>
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<strong>Follow-up care</strong></p>
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It is vital that children MIS-C will need to see a paediatric cardiologist two or three weeks after leaving the hospital. The syndrome can cause the wall of the heart to be inflamed (myocarditis). Patients with myocarditis will be restricted from activities like exercise or sports for a period of time. Children treated with steroids or a biologic medicine should also follow up with a paediatric rheumatologist.</p>
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<strong>Prevention</strong></p>
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The best way to prevent MIS-C is to keep taking steps to help avoid exposure to Covid.</p>
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Wash hands often using soap and water for 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.</li>
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Avoid people who are sick and keep a 6-foot distance between your child and people outside your household.</li>
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Wear cloth face coverings.</li>
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Clean and disinfect “high touch" surfaces daily.</li>
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Wash laundry and plush toys as needed on the warmest setting advised and dry them fully.</li>
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