Pune: No alarming rise in MIS-C in children, but preparedness stepped up

Anticipating the likelihood of a rise in cases of multisystem inflammatory syndrome in children (MIS-C), the Pune paediatric Covid task force has urged parents to remain vigilant and ensure correct clinical diagnosis.

Dr Aarti Kinikar, chairperson of the Pune division paediatric Covid task force told The Indian Express that in the entire year there have been 25 such cases of MIS-C in children at Sassoon General Hospital and, fortunately, they were not lost. Early detection is vital here, she said.

According to The Lancet, it is not known what triggers the condition but it is thought to be a rare immune overreaction that occurs approximately four to six weeks after a mild or asymptomatic SARS-CoV 2 infection. The symptoms would include fever for three days, rash, eye infection and gastrointestinal symptoms like diarrhoea, stomachache and nausea In some rare cases the condition can lead to multi-organ failure.

Dr Pradeep Awate, State surveillance officer who is also part of the task force said that preparedness levels have been stepped up. “While there is no reason for panic due to limited scientific evidence on the rise of Covid in children, parents should remain vigilant and ensure correct clinical diagnosis,” Dr Awate said.

Dr Kinikar said that Sassoon was a tertiary care hospital that gets referrals from other centres. “Overall there have been 181 Covid positive children treated at Sassoon general hospital. Children with SARI like illness are around 49-55 and slowly increasing,” Dr Kinikar said. From January till April there were 55 children with Covid of which eight are newborns. Seven newborns were detected with Covid in April while one was in March.

The paediatric Covid task force is also focussing on orphanages and juvenile homes to pick up early cases of Covid in children. “We need to step up awareness especially among parents to be on an alert in case the child is not his/her usual self, has a fever for three days, and symptoms like rash and abdominal pain. Parents must take early treatment,” she said.

“Treatment is symptomatic, but on day four and five the child can go into shock and a team of intensivists, cardiologists and others are involved in the ICU management of the child. IV immunoglobulin is expensive and we need more donors,” she said.

The task force has identified hospitals like Bharati, KEM, Ruby, Deenanath, Jehangir, YCM and Sassoon general hospital apart from PMC’s Rajiv Gandhi hospital for gathering information on ICU bed availability and the number of paediatricians. In the case of children with MIS-C, the ICU management teams are crucial.

“Last year we had two deaths of children due to comorbid conditions and SARS-CoV2. However, from Jan to April there were four deaths where children between 2 and eight years died. They were born with defects and had conditions like a congenital anomaly, chromosomal disorder, liver disease and mentally challenged. Parents must ensure that children with comorbid conditions get better nutrition,” Dr Kinikar said.

Dr Rajan Joshi , Head of the Department of Paediatrics, Deenanath Mangeshkar hospital said that essentially the MIS-C condition occurs post-Covid infection.“The body’s immune system starts acting against the virus and your own antibodies attack the system. Hence it cannot be predicted which child is at risk. These antibodies then can affect the heart, skin and other tissues. Fortunately, all the 30 children with MIS-C have been treated and discharged from our hospital,” he said.

Dr Sanjay Mankar, paediatric infectious diseases consultant at Bharati hospital and one of the task members said early diagnosis was crucial for ensuring proper treatment. “This is a post-Covid phenomenon where the child may not be positive on RAT and RT-PCR tests. However, clinical presentation like fever for three days, abdominal pain and rash should not be ignored,” he urged.