As of today, 52 children in New York City are reported to have pediatric multisystem inflammatory syndrome, a rare but serious illness that’s believed to be linked to the coronavirus. The latest report of the mysterious affliction, which began appearing in and around the city over the past month, is causing further concern following the tragic death of a 5-year-old child in New York City last week. “It’s sobering, it’s bluntly frightening, and I want to say to parents out there, if you’re hearing this information about pediatric multisystem inflammatory syndrome and it sounds scary, it does sound scary,” said New York Mayor Bill de Blasio of the syndrome in his daily COVID-19 briefing today. “I’m speaking as a parent myself. It’s something we did not see essentially throughout March and April. It was not something that the health-care community saw on their radar. Then in the last week or two, suddenly, we’re seeing something that’s very troubling.”
While fear of pediatric multisystem inflammatory syndrome, which was first reported in the U.K., is mounting intensely in New York City, there have also been sporadic reports of this new, purportedly COVID-19-related illness across the country—including Connecticut, Louisiana, Mississippi, and California. Nearly 100 children in the U.S. are suspected to have developed pediatric multisystem inflammatory syndrome (most tested positive for the coronavirus or had positive antibody tests), and its emergence marks a critical turning point for the widely held understanding of the coronavirus and its impact on children. In his testimony in front of a Senate committee on the U.S. coronavirus response today, Dr. Anthony Fauci warned against believing children are largely safe from the coronavirus. “I think we better be careful [that] we are not cavalier in thinking that children are completely immune to the deleterious effects,” said Fauci in response to Senator Rand Paul after the Kentucky Republican asserted that the longtime director of the National Institute of Allergy and Infectious Diseases (NIAID) isn’t the “end all” of knowledge and that it would be “kind of ridiculous” to suggest that schools shouldn’t reopen in the fall.
While pediatric multisystem inflammatory syndrome is sure to be a major factor in policy deliberations around school reopenings, gaining a better understanding of the risk is currently top of mind for parents. Here, doctors answer frequently asked questions using the knowledge they have now.
What are the symptoms?
Similar to Kawasaki disease, which typically affects children under five, and toxic shock syndrome, the most common symptoms of pediatric multisystem inflammatory syndrome are a prolonged fever of five or more days, severe abdominal pain, diarrhea, rash, and lethargy, says Dr. Tanya Altmann, a pediatrician and spokesperson for the American Academy of Pediatrics. “We are asking parents if their kids have a prolonged fever, look really sick, have trouble breathing, can’t keep down fluids, or are in severe pain to seek medical care right away as prompt treatment can help with recovery,” explains Altmann. Why certain children are more at risk than others remains unknown, but Altmann posits that it likely has to do with a child’s immune-system response to the virus.
How fatal is it?
While any risk is unwelcome, particularly as emotions continue to run high, Altmann stresses that pediatric multisystem inflammatory syndrome is extremely rare. “Most kids who contract COVID-19 have mild illness and fully recover,” she says.
Dr. Edith Bracho-Sanchez, a primary-care pediatrician at New York-Presbyterian Hospital’s Broadway Practice who has been treating cases of pediatric multisystem inflammatory syndrome, echoes this assertion—and feels especially inclined to provide solace to the more vulnerable populations in the U.S. “As someone working in New York City within the immigrant community, a lot of my patients have parents that are essential workers,” explains Bracho-Sanchez. “I treat the kids of grocery store workers, MTA workers, and factory workers. These are the children who’ve been most exposed to COVID-19, and most of them have a very mild illness—if they have an illness at all. That still holds true.” That being said, Bracho-Sanchez believes this is a moment to revisit preconceived notions about the coronavirus. “We’ve been thinking about schools simply as vehicles of transmission for staff and parents, but now it goes beyond just bringing it home to the adults,” says Bracho-Sanchez. “We have reason to pause and rethink things because now it’s also about the safety of the children too.”
As for what to expect for the coming weeks and months in regards to pediatric multisystem inflammatory syndrome, there are still a lot of unknowns. “The relationship to COVID-19 is not pinned down—it’s still a little bit uncertain, but certainly there is a temporal association,” says Dharushana Muthulingam, an infectious-disease physician, researcher, and instructor at Washington University School of Medicine in St. Louis. “Basically, after there is a COVID-19 spike, there is a cluster of these cases.” Thinking about the bigger picture, Muthulingam notes that since children are largely asymptomatic carriers, it’s how they affect adults that is still likely to be the leading concern in terms of whether schools are reopened in the fall or not. In the interim, the best course of action for parents is to concentrate on the facts and not let fear take over. “This condition is certainly concerning and, of course, frightening to hear about, but it looks like things we know, whether that’s Kawasaki or other viral illnesses, and can be responsive to intensive care,” says Muthulingam. “The best way for people to feel like they have control over the situation is to keep preventing COVID-19 the best they can, and if a child is sick, take them to their pediatrician and seek out care. We should all be vigilant, but this syndrome is rare—I don’t want people to panic about it.”
Originally Appeared on Vogue