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CDC warns doctors about childhood illness linked to Covid-19

Doctors are seeing an increase in multisystem inflammatory syndrome in children, or MISC -- a condition that experts say might be linked with the novel coronavirus. CNN's Sanjay Gutpa reports.

Posted: May 15, 2020 5:01 AM
Updated: May 15, 2020 5:01 AM

The US Centers for Disease Control and Prevention issued a health advisory to thousands of doctors across the country Thursday, advising them to be on the lookout for a troubling new syndrome that may be associated with Covid-19 infection.

The syndrome, called multisystem inflammatory syndrome in children (MIS-C), has been seen in children across Europe and in at least 18 states, plus Washington, DC.

Doctors in the UK first alerted other doctors to the syndrome in April. Since then physicians in other countries, including Italy and France, have reported clusters of similar cases.

"Beginning about four or five weeks ago, in Europe they stared to describe a form of what really sounded like toxic shock," said Dr. Jeffrey Burns of Children's Hospital and Harvard Medical School in Boston. Burns has been coordinating a series of regular video chats among doctors around the world comparing notes on pediatric cases of Covid-19.

"There were just a few at first and then more," Burns told CNN.

At first, the cases were believed to be Kawasaki disease, a rare, inflammatory condition that usually involves the major arteries and the heart. But there were too many cases for it to be Kawasaki, and the doctors agreed it was a different inflammatory syndrome. Many, but not all, of the children tested positive either for current Covid-19 infection, or a past infection.

It's only rarely fatal and most children recover, Burns said.

"During March and April, cases of COVID-19 rapidly increased in New York City and New York State. In early May 2020, the New York City Department of Health and Mental Hygiene received reports of children with multisystem inflammatory syndrome," the CDC health advisory reads.

New York Governor Andrew Cuomo said earlier Thursday that the state Department of Health was investigating 110 cases of the syndrome. "It tends to present in children who were exposed to the Covid virus and actually now have the antibodies ... or still test positive for the Covid virus," Cuomo said at a news conference in Albany.

The CDC said it was still gathering information about the cases.

"There is limited information currently available about risk factors, pathogenesis, clinical course, and treatment for MIS-C. CDC is requesting healthcare providers report suspected cases to public health authorities to better characterize this newly recognized condition in the pediatric population."

The advisory provides a case definition to guide doctors:

  • An individual aged under 21 years presenting with fever, laboratory evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multisystem (more than 2) organ involvement (heart, kidney, renal, respiratory, blood, gastrointestinal, dermatologic or neurological); AND
  • No alternative plausible diagnoses; AND
  • Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms
  • Fever above 38.0°C (100.4F) for 24 hours or more
  • Abnormal blood tests including: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin
  • Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C
  • Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection

Mississippi Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 36680

Reported Deaths: 1250
CountyConfirmedDeaths
Hinds304154
DeSoto200920
Madison150839
Jones123149
Harrison118316
Rankin113719
Neshoba104577
Forrest104343
Lauderdale97281
Scott83115
Jackson80419
Washington75313
Copiah67516
Leake63520
Lee63022
Grenada6259
Oktibbeha62328
Warren60021
Holmes59841
Lamar5847
Wayne56819
Yazoo5667
Lowndes54917
Leflore53956
Lincoln53835
Pike51120
Lafayette5094
Sunflower5058
Panola4616
Monroe46036
Simpson4533
Covington4505
Bolivar41618
Tate39513
Attala38624
Newton37710
Adams36720
Pontotoc3636
Marion34912
Claiborne31511
Pearl River30832
Chickasaw30219
Winston30211
Marshall2973
Jasper2826
Noxubee2799
Walthall2748
Clay26211
Smith25612
Union25612
Coahoma2356
Clarke22825
Lawrence2162
Yalobusha2089
Tallahatchie1974
Montgomery1863
Kemper18414
Carroll18311
Humphreys17410
Calhoun1705
Hancock15213
Itawamba1478
Tippah14711
Jefferson1373
Webster13511
Prentiss1274
Tunica1263
George1253
Jefferson Davis1254
Greene11610
Alcorn1112
Amite1113
Tishomingo1091
Quitman1011
Wilkinson1019
Perry914
Stone772
Choctaw764
Franklin572
Sharkey480
Benton470
Issaquena111
Unassigned00

Alabama Coronavirus Cases

Confirmed Cases: 54768

Reported Deaths: 1096
CountyConfirmedDeaths
Jefferson7012170
Mobile5061140
Montgomery4599112
Tuscaloosa274353
Madison25359
Marshall205012
Shelby176425
Lee164737
Morgan13975
Baldwin134111
Walker111332
Elmore107622
Etowah106914
Dallas10189
DeKalb10017
Franklin95016
Unassigned77728
Autauga71515
Russell7130
Chambers68530
Cullman6686
Limestone6653
Butler65529
Houston6417
Tallapoosa63069
Lauderdale6006
St. Clair5983
Calhoun5545
Colbert5286
Escambia5128
Lowndes49222
Pike4805
Jackson4422
Coffee4364
Covington43512
Talladega4177
Dale4061
Barbour4022
Bullock37810
Hale36323
Marengo36111
Chilton3452
Blount3311
Clarke3236
Wilcox3158
Marion30914
Winston3095
Sumter29713
Pickens2786
Randolph2759
Monroe2683
Perry2552
Conecuh2388
Bibb2271
Macon2229
Choctaw22012
Greene2009
Henry1573
Washington1529
Lawrence1460
Crenshaw1343
Cherokee1317
Geneva1010
Fayette901
Clay892
Lamar891
Coosa671
Cleburne481
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