Amid the second wave of Covid-19 in South Africa, Western Cape health officials have warned parents to be on the lookout for another disease primarily affecting children. The provincial health department this week noted that there have been 35 reported cases of Multisystem inflammatory syndrome in children (MIS-C) at Red Cross Hospital, with a professor warning that total figures are likely higher.
The condition has seen different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. An associate professor at the Red Cross War Memorial Children’s Hospital and Paediatric Rheumatology, Prof Chris Scott, spoke to VOC’s Breakfast show on Tuesday and explained what the disease was all about.
“It appears some kind of delayed immune reaction to covid-19 infection. About a month after the initial infection, children present with features of uncontrolled inflammation in various organs including in the eyes, lips, skin, joints, muscle and sometimes the heart,” he elaborated.
“Children come in pretty sick with this, but we’re able to manage it quite effectively with current therapies,” he said.
According to the Lancet, the first 23 cases of MIS-C treated at The Red Cross War Memorial Children’s Hospital and the Tygerberg Children’s Hospital, from June 4 to July 24, 2020. Since then, Prof Scott surmised that the figure may have risen to up to 80 cases in the Western Cape.
“With the surge of the pandemic further north throughout the continent, we expect continued reports of MIS-C in South Africa and sub-Saharan Africa. We encourage regional child health professionals to practice vigilance and create structured referral pathways to specialist centres,” wrote the Lancet.
The professor said that the main symptom that brings children to hospital is the fever, which could be persistently very high or fluctuating. Other symptoms include:
– Swollen hands
– skin rash
– red eyes
– red lips
– loss of appetite
“We then do our special investigations to look and see if there are other organs involved, specifically the heart which we are concerned about,” he said.
“The chances of children getting this are still low. But if you had covid-19 in your house or you know your child has been infected, then it’s something to bear in mind if the fever does come up,” he noted.
When asked whether or not the disease is evolving, the professor said that it doesn’t appear to be. But he noted that every case helps officials understand it better. He explained that nurses and doctors have become attuned to spotting the symptoms and, as a result, hospital admissions have dropped due to MIS-C being caught and treated earlier. He noted however, that proper investigation into the best course of treatment for around 1000 patients would provide a better overview.
“It’s a new syndrome all over the world. We don’t know what the vest evidence or treatment is. What we have been doing is based on treating other illnesses that present in a similar fashion. These treatments seem to be working, although this is a particular disease,” he said.
“These treatments seem to be working but exactly how to apply them and which are the best ones to start with and so on, we’re not sure. But there are a number of ongoing studies internationally, including with us, looking at how this is best managed,” he added.
According to the professor, combining medical and academic knowledge is crucial to getting a grip on the disease. This, he said, included collaboration with the National Institute of communicable Diseases and the World Health Organisation.
“Working together is important. My colleague Kate Webb has put together a working group for Mis-C. We’re collaborating with doctors from all over South Africa to try to understand this better, discuss and collect cases.”
“We’re all working together to try and understand this as quickly as possible,” he said,
The best thing to do, according to Prof Scott, is to follow the same protocols recommended to prevent Covid-19; such as social distancing, wearing of masks and regular hand washing – particularly during the festive time.