The Rappahannock Area Health District is reporting the first confirmed case of a rare inflammatory illness associated with COVID-19 that strikes children.
The local child who contracted the illness has recovered. Health officials didn’t provide information about age, gender or residence to protect the child’s privacy.
The illness is known as Multisystem Inflammatory Syndrome in Children, or MIS-C. It was first identified in Europe in late April, in areas where there had been widespread cases of the novel coronavirus. Cases showed up in New York City in early May.
To date, there have been seven children diagnosed in Virginia: five in Northern Virginia, one in the Shenandoah Valley and one in the Fredericksburg area. No deaths from MIS-C have been reported in Virginia, but health officials believe the illness is responsible for the deaths of at least four children in New York and Louisiana.
MIS-C can cause problems with a child’s heart and other organs, according to health officials. In many cases, children have a fever lasting several days and may show symptoms of irritability or decreased activity, abdominal pain without another explanation, diarrhea, vomiting, rash, conjunctivitis, lack of appetite, red or cracked lips, red or bumpy tongue or swollen hands and feet.
Some of the symptoms are similar to conditions children show when they have other common illnesses, but those with MIS-C “usually are acting a little sicker,” said Dr. Allison Markowsky, medical director for Children’s National pediatric program, which has a partnership with Mary Washington Healthcare.
Her team of doctors takes care of newborns and children at Mary Washington Hospital and Stafford Hospital. Since May, the team has evaluated “three or four” children showing symptoms of the syndrome and sent them to Children’s National for further diagnosis.
She stressed that only a small portion of children who get COVID-19 will develop the syndrome, but there’s one factor that makes this condition more frightening. Unlike the virus, which tends to more seriously impact those with underlying health conditions, MIS-C has sickened otherwise healthy children, Markowsky said.
“Overall, I think COVID-19 hasn’t been affecting children as seriously, but it’s a real and serious threat, and it’s important to take it seriously,” she said.
Parents are urged to contact their doctor if their child becomes ill with a continued fever or other symptoms of the syndrome. Those diagnosed with it usually have an active infection from the virus or have developed antibodies, meaning they’ve recovered from it, Markowsky said.
“Unfortunately, this serves as a reminder that much of our community remains susceptible to this disease,” said Dr. Donald Stern, acting director of the local health district. “I urge all local health care providers to immediately report any patient who meets these criteria to the local health department.”
Stern said the case was identified after the fact, based on new information that became available related to the syndrome. He wouldn’t say when the child became ill.
Because COVID-19 is a novel virus—meaning it’s never been seen before—“our understanding of this disease as a scientific community is constantly growing,” Stern said. He said identifying the case “adds to our knowledge of the spectrum of COVID-19 related disease.”
In May, when the syndrome was first reported in the United States, local pediatricians noted that a virus often creates an inflammatory response in children as their bodies try to fight off the infection.
It does the same in adults, but “with children, you have smaller margins of error,” said Dr. Linda Purcell, owner of Preferred Pediatrics in Spotsylvania. They tend to react more because they haven’t been exposed to as many viruses and haven’t built up a proper immune system, she said.
Dr. Pamela Mancini, whose pediatric practice is in Spotsylvania, described it this way:
“Your immune system is great, but sometimes it overdoes things, and when it does, it’s like shooting a bazooka at your house to get rid of mice,” she said. “You get rid of the mice, but then your house is all burned up.”
The state health department divides COVID-19 cases by age, listing children through age 9 in one category and those age 10–19 in another.
As of Friday, 115 young children had confirmed cases of the virus in the local health district, which includes Fredericksburg and the counties of Caroline, King George, Spotsylvania and Stafford.
Two of the 115 children have been hospitalized with their symptoms.
Another 246 patients ages 10–19 tested positive, and three of them ended up in the hospital.
The two youngest age groups make up about 14 percent of local cases—which totaled 2,628 as of Friday. That’s almost twice as many as those on the opposite end of the spectrum.
People age 70 and over make up 7.6 percent of local cases, but represent 73 percent of the deaths. No one under age 40 has died in the local health district.
“While we know older adults and people with underlying medical conditions are at higher risk for severe cases of COVID-19, there can be serious complications in people of all ages,” said Allison Balmes–John, spokesperson for the local health district. “We all need to continue to do our part to slow the spread of disease in order to keep community members of all ages safe.”
Cathy Dyson: 540/374-5425