Tamil Nadu: Multisystem Inflammatory Syndrome Seen as Threat to COVID-Recovered Lower Age Group Children

Chennai: Multisystem Inflammatory Syndrome (MIS-C) among children recovered from COVID-19 in Tamil Nadu has seen an increase, mainly  in the 0-12 age group.

The children who are asymptomatic and those who have not tested positive, but have come in close contact with positive patients are prone to develop MIS-C even as the symptoms could vary among children,

Neonatologists and pediatricians have, therefore, called for early detection and treatment to save children from such life threatening risks. 

The increase in cases among the children in the second wave of COVID-19 also calls for a change in the country’s vaccine policy with experts demanding vaccines for the lower age groups, like in several countries. 

EARLY DETECTION VITAL

MIS-C is impacting children after 2-6 weeks of recovery from COVID-19. The condition is marked by severe inflammation of one or more parts of the body, including the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal organs. 

Dr C S Rex Sargunam, former director of Institute of Child Health and Hospital for Children, Chennai, said: “Early detection of MIS-C is vital for recovery. Even children who have not tested positive can develop inflammation if they have come in contact with COVID positive patients”.

In Tamil Nadu, a total of 85,116 children below the age of 12 contracted the infection till June 13, 2021.

Though the number of such cases was very low during the first wave, there has been a rise in fresh cases in the second wave. Since the government has not issued any details of the MIS-C, parents whose children were infected have took to social media platforms to create awareness.

Message sent by a parent in WhatsApp on the status of his son infected by MIS-C

Parents should not be reluctant to share details of contact of children with positive patients. I have referred a child for MIS-C for further treatment after the parents disclosed the details of contact of the child only after two days of fever. The reluctance in taking necessary tests and treatment could result in danger”, Dr Rex said. 

The government of Kerala has reportedly decided to announce MIS-C as a notifiable disease. 

NEED STOCK OF MEDICINES

The children with MIS-C are generally treated with immunoglobulin and steroids. Experts have warned of adverse effects in the heart, liver, and kidneys of children if treatment is delayed. The need to stock medicines across the state has also been recommended. 

Dr Shanthi, Secretary of the Doctors Association for Social Equality, said: “The number of MIS-C cases is increasing among children proportionate to the active cases. There is no need to panic, but parents should not take fever and other symptoms lightly. If the symptoms survive, the C-reactive Protein (CRP) test must be taken to start medication or hospitalisation as per the requirement”. 

Experts have called for enough stock of medicines to treat children, since stocks were concentrated only in city-based hospitals. 

“Medicines like immunoglobulin are also expensive. It is not sufficient to keep stock of such necessary medicine in only a few select hospitals. The state government has to ensure the availability of stock across all districts and announce a protocol for treatment based on expert advice”, Dr Rex said.

Considering the increasing infection and the risks and difficulty in taking CT scans for children, Dr Rex called for practicing ultrasonography for children. “It is simple equipment which needs small training for pediatricians. We have to rule out the possibilities of pneumonia in the future as well”, he added.

‘EXTEND VACCINES TO CHILDREN’

The second wave has affected middle aged persons and children in large numbers. Deaths among women and youth have also increased during the wave. The threat of post-COVID complications have called for a change in vaccine policy as well.

Dr Rex, who is also the president of Tamil Nadu Health Development Association (TNHDA), said: “Many countries have started vaccinating children as well. Considering the impact of the second wave and the increasing infection among children, it's high time we vaccinate everyone irrespective of their age”.

Commenting on the shortage of vaccines in India, Dr Rex said:,“India has the potential to manufacture vaccines, if the Union government is prepared to permit PSUs and Integrated Vaccine Complex (IVC) in Chengalpattu to manufacture vaccines”.