A mysterious illness has been flagged in children between the ages of 2 and 15, according to an alert issued by the New York City Health Department on Monday. Fifteen children in New York City were hospitalized with similar symptoms from April 17 to May 1. Officials say the cases are compatible with a multi-system inflammatory syndrome and may possibly be linked to the novel coronavirus. According to the alert, the mysterious illness includes persistent fever and is similar to components of Kawasaki disease or toxic shock syndrome.
While Kawasaki disease is usually treatable and most children recover, the disease can also be deadly, as it can limit blood flow to the heart. Symptoms vary but include many of those present in the recently hospitalized children, including rashes and fever. Based on antibody testing, many but not all of the children either tested positive for coronavirus or were found to be previously infected, the health department said. As of the alert, none of the children have died as a result of the illness, but more than half of the cases required blood pressure support, with one-third needing a ventilator to breathe. Meanwhile, “the full spectrum of the disease is not yet known,” the health department said.
According to The New York Times, state officers are also investigating the unknown disease, which was the subject of an international webinar last week. “So far, from what we understand, this is a rare complication in the pediatric population that they believe is related to Covid-19,” Howard Zucker, the state health commissioner, told the Times. “We are following it very closely.” While the disease seems rare, it has been gaining attention in recent weeks with similar cases reported in the United Kingdom, Spain, and Italy. The Paediatric Intensive Care Society United Kingdom warned that some children were growing ill with a syndrome that may be linked to the coronavirus, CNN reported. Children throughout Europe have been hospitalized with heart conditions in addition to the symptoms of diarrhea, rash, and fever. While no deaths have been recorded globally, many of the affected children in Europe have also tested positive for COVID-19.
Officials have urged parents to seek medical care if their children experience high fever, abdominal pain, or develop rashes. “Even though the relationship of this syndrome to Covid-19 is not yet defined, and not all of these cases have tested positive for Covid-19 by either DNA test or serology, the clinical nature of this virus is such that we are asking all providers to contact us immediately if they see patients who meet the criteria we’ve outlined,” Oxiris Barbot, the city’s health commissioner, said in a statement published by the Times.
While the coronavirus pandemic has shown to be more deadly to the elderly, in New York City at least six children have died of COVID-19, data from the health department found. According to the Times, reports of the unexplained syndrome have circulated for days but the alert was the city’s first warning to doctors in regards to it. “Only severe cases may have been recognized at this time,” the alert said. According to CNN, a similar case has been reported at the Stanford Children's Hospital in California.
As some U.S. states and countries are in the process of deciding when schools will reopen, this alert serves as a reality check that children can also become seriously ill from the virus. While the number of cases is small and only a few children seem to be infected by the coronavirus, the risk is far too high to take without more information on what this mysterious illness is. New studies have found that while children are likely to only experience mild symptoms, the chance of them spreading the virus remains high. Researchers warned that states should reconsider opening schools before the summer, as evidence suggests an increase in cases to dangerous levels is likely.
“My simulation shows that yes, if you reopen the schools, you’ll see a big increase in the reproduction number, which is exactly what you don’t want,” Marco Ajelli, a mathematical epidemiologist said. According to the Times, countries including the United Kingdom, Israel, France, and Germany have either reopened schools or plan to, but the rate of transmission in those countries is low compared to the U.S. While the data does not say closing schools is the answer to stopping the spread of another coronavirus outbreak, researchers estimate that a surge can be reduced by 40 to 60% should schools remain closed.