What You Need to Know About MIS-C in Children

Since late spring 2020, the Centers for Disease Control and Prevention (CDC) has been tracking a serious condition in children associated with COVID-19. Multisystem inflammatory syndrome in children, known as MIS-C, is a new health issue that requires immediate medical attention. While many questions remain about why some children develop it and others do not, the good news is that MIS-C is not common, and most affected children survive with hospital treatment.

What Is MIS-C?

MIS-C is an extremely rare condition affecting children where the body’s own immune system overreacts, causing dangerous swelling (inflammation) in multiple different parts of the body. This includes the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, such as the liver, gallbladder, or pancreas. The CDC reports that most cases are in children between the ages of 1 and 14, with an average age of 8. MIS-C can, however, affect young people up to age 21.

What Causes MIS-C?

While researchers don’t know yet what causes MIS-C, most children with the condition have had the virus that causes COVID-19. Because some people infected by coronavirus may not show any signs of illness and children typically don’t have serious COVID-19 symptoms, you may not have even known that your child was exposed or infected. MIS-C itself is not contagious.

What Are the Symptoms of MIS-C?

In nearly all known cases of MIS-C, children had a fever of 100.4 degrees or higher for at least 24 hours, and most also had low blood pressure. Left untreated, the widespread inflammation from MIS-C can cause long-term organ damage. That’s why it’s important that your child get immediate care if you suspect MIS-C. Signs of MIS-C vary, but you should contact your child’s physician, nurse, or clinic right away if he or she suffers any of these symptoms:

• Abdominal pain, vomiting, or diarrhea
• Bloodshot or red eyes
• Feeling extra tired
• Fever that lasts for several days
• Neck pain
• Skin rash

Take your child to the emergency room immediately if he or she shows these emergency warning signs of MIS-C:

• Bluish lips or face
• Confusion
• Difficulty waking up or staying awake
• Pain or pressure that does not go away
• Severe stomach pain
• Trouble breathing

Who Gets MIS-C?

MIS-C remains a rare condition, with the CDC reporting fewer than 800 cases [JM1] in the United States. MIS-C does not appear to be associated with children who have a chronic illness that compromises their immune system. The CDC has, however, found some commonalities among children who have had the condition, including:

• More than 70% of MIS-C patients are Hispanic/Latino or Black
• 99% of children tested positive for coronavirus
• Most children developed MIS-C approximately two to four weeks after being infected with COVID-19

How Will My Child’s Doctor Diagnose and Treat MIS-C?

There is no specific test to diagnose MIS-C. If your child shows signs of MIS-C, your child’s health care team will test for COVID-19 and check for unusual inflammation through:

• Abdominal ultrasound
• Blood work
• Chest X-ray
• Heart ultrasound

Most children with MIS-C will need to be hospitalized, and many need to be in the pediatric intensive care unit (ICU) where they can receive specialized care. Treatment involves medications targeting the immune system to reduce inflammation that could permanently damage vital organs, such as the heart or kidneys. Drugs such as steroids, blood thinners, antibiotics and pain relievers, along with fluids are used to treat MIS-C. While children with MIS-C are not contagious, the condition is associated with exposure to coronavirus, so infection control precautions will be taken at the hospital.

What Is the Prognosis for MIS-C?

MIS-C can be serious, even deadly, but the good news is that most children with the condition get better with medical care. Medications can control the inflammation and help prevent lasting organ damage, especially involving the heart. Doctors, such as pediatric cardiologists, will need to do checkups after discharge from the hospital to track the health of children who’ve had MIS-C.

How Can I Protect My Child?

The best way to keep your child safe from MIS-C is to prevent exposure to coronavirus. Because coronavirus spreads mainly from person to person and some people do not show any symptoms even when they have the virus, the CDC recommends:

• Avoiding close contact and staying at least 6 feet apart from anyone outside your household
• Avoiding touching your eyes, nose and mouth with unwashed hands
• Cleaning and disinfecting frequently touched surfaces daily (doorknobs, light switches, counters, phones, bathrooms, etc.)
• Covering coughs and sneezes with a tissue and washing your hands immediately
• Covering your mouth and nose with a face mask when around others
• Washing your hands often with soap and water or using sanitizer that is at least 60 percent alcohol

In addition, be sure your child and everyone else in your family gets a flu shot. Getting the current flu vaccine is the safest, single most effective way to protect your child and your family against the flu. Avoiding the flu this season is especially important because the flu and coronavirus have similar symptoms and getting both of these contagious respiratory illnesses is dangerous.

Where Can I Go for Health Care for My Child?

If you have any questions about your child’s health, or if something about your child doesn’t seem quite right, trust your instincts, and call your child’s doctor. You can learn more about protecting your family by visiting the AdventHealth Coronavirus Resource Hub.

What’s Next with MIS-C?

As the pandemic has progressed, larger numbers of children have become infected with coronavirus. Health experts don’t know whether this increase in COVID-19 cases among children will also increase the number of MIS-C cases. The CDC is monitoring MIS-C cases to learn more about risk factors for the condition, how the illness progresses and how to identify and distinguish MIS-C from other inflammatory illnesses such as Kawasaki disease and toxic shock syndrome.