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COVID-19 and Kawasaki Disease: What Parents Need to Know

News coverage of COVID-19 and its impact on the world have dominated the headlines. Until recently, children were thought to be not significantly affected. This has changed after there were reports from the United Kingdom of a small number of cases of critically ill children presenting with unusual symptoms.

Within a few weeks, clusters of sick kids with, what is being called, “Pediatric Multisystem Inflammatory Syndrome” or PMIS, started to appear in New York City and several other states. Some of these cases resembled a rare inflammatory illness called Kawasaki Disease.

What Is Kawasaki Disease?

Kawasaki Disease is a rare inflammatory disease that causes blood vessels to become inflamed or swollen throughout the body. We do not know what causes Kawasaki Disease. More than 80% of the children who get it are younger than 5 years of age.

The hallmark of Kawasaki Disease is a persistent high fever (over 101°F) for at least 4 days in addition to rash, redness to eyes, lips/tongue, swelling and redness to hands/feet and neck swelling. Kawasaki Disease Shock Syndrome is a rare form of this disease characterized by severe inflammation resulting in a child becoming critically ill.

What Is Pediatric Multisystem Inflammatory Syndrome (PMIS) and Why Do Doctors Think This Is Related to COVID-19?

On April 27, 2020 the United Kingdom released a statement describing a number of children who were presenting critically ill. They had some clinical features of Kawasaki Disease and Kawasaki Disease Shock Syndrome.

Soon after, multiple reports of cases came from across Europe and in the United States. Some PMIS patients were found to carry the virus causing COVID-19 and some had proteins in their body showing that they previously had the infection. A significant number of patients were exposed to someone with COVID-19 infection.

A key finding of PMIS is evidence of severe inflammation, which is similar to Kawasaki Disease and like Kawasaki Disease, children with PMIS also have high fevers and can present with red eyes, and rash. However, PMIS patients tend to be older than typical Kawasaki Disease patients. Some of their blood tests, including markers of inflammation, are more abnormal than patients with Kawasaki disease.

Severe abdominal pain and diarrhea is another common complaint with PMIS. So far, we know the similarities between these two diseases, but we do not have sufficient information to fully understand the differences.

At this time, we do recommend seeking medical evaluation with your primary care doctor if your child has persistent fevers over 101°F as well as severe abdominal pain, diarrhea, or rash that could not be explained by another cause.

Call East Cary Family Physicians to seek an appointment. Also note that ECFP is providing Tele-Health option for health visits.

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Coronavirus (COVID-19): Everything You Need to Know

What is the coronavirus?

When we think of coronavirus, we think of the outbreak that is currently happening. However, there are common strains of the virus that usually cause mild to moderate upper respiratory illnesses. In fact, most people are infected with a coronavirus at least once in their lifetime. The strains of coronavirus that appear in the news are the highly infectious and aggressive mutations that cause severe outbreaks and symptoms, such as SARS in 2003, MERS in 2012, and the current outbreak of COVID-19.

How does COVID-19 spread?

Currently, we know that COVID-19 spreads via respiratory droplets, where an infected person coughs or sneezes and the droplets are inhaled by another person. It is thought that a person is most contagious when they are most symptomatic, but there is some evidence that spread is possible before symptoms exist.

What are the symptoms of COVID-19?

The primary symptoms of the virus are fever, cough, and shortness of breath. These symptoms range from mild to severe illness and death. At this time, the CDC believes that symptoms may appear between 2-14 days after exposure.

How do you know if you have COVID-19 or Influenza?

In the United States, the risk of getting COVID-19 is currently low; it is much more likely that a person is infected with Influenza. If you recently traveled to China, or another country that has reported infections, or were recently in the presence of someone that was diagnosed with COVID-19, please call East Cary Family Physicians and inform them of your exposure. While we want to be aware of your health status, currently only hospitals are able to test for COVID-19 so you will be referred for testing if we deem necessary. If you do not have any known exposures, it is likely that you have Influenza and you can make an appointment at East Cary Family Physicians to test for Influenza.

How do you prevent infection?

Currently, no vaccine exists to prevent COVID-19. If you or someone you know is sick, it is important to use the same precautions you would use for other respiratory viruses, including: avoiding close contact with those who are sick; staying home when you are sick; cleaning surfaces with a household cleaning spray; wearing a facemask if you are sick; and washing your hands often with soap and water for at least 20 seconds.