KOLKATA: Even as the Covid-19 graph in Bengal continues to drop sharply, doctors in the city are worried about rising cases of multi-system inflammatory syndrome in children (MIS-C), many of which are turning out to be severe.
Doctors fear MIS-C cases will continue to rise sharply in the next few weeks.
“Last year we started getting MIS-C cases from end-November and beginning of December when Covid cases were on the decline.
For the second wave also, the peak is over and MIS-C cases have now started coming in.
We have got around 25 such cases in the past two weeks,” said paediatric intensivist Prabhas Prasun Giri, associate professor at Institute of Child Health (ICH), Kolkata.
A condition caused by delayed immune response to Covid, MIS-C is like post-Covid complications that adults face.
Children suffer from symptoms like fever, diarrhoea, swelling in the neck, abdomen pain and seizures.
While some of the kids are found to have tested positive earlier, many were never tested as they were asymptomatic but have developed antibodies suggesting that they had been infected..
“While last year hardly any children had a history of Covid, this year we are finding more children with known history of the infection.
This could be because this time parents are testing children too in case anyone in the family is infected,” said paediatric rheumatologist Priyankar Pal, professor of paediatrics at ICH, who has seen around 14 patients in the past few weeks.
According to Medical College assistant professor Dibyendu Raychaudhuri, MIS-C usually occurs two to six weeks following recovery from acute Covid-19 infection.
“MIS-C is manifested clinically in children up to 19 years old as fever for more than three days, rashes, red eyes, swelling and redness of hands and feet, shock, hypotension, depressed cardiac function, dysrhythmia, diarrhoea and vomiting.
Parents need to be aware of these symptoms so that the child gets timely medical intervention,” said Raychaudhuri, whose unit has already treated a few children.
Pediatrician Sumita Saha and her team have already come across four children in the last two weeks and three of them needed intensive care at Fortis Hospital.
“The number of MIS-C is already slightly higher than what we came across last year.
So I am concerned that the numbers will swell further.
And unlike last year we are getting teenagers with adult-like pneumonia,” said Saha.
Currently six children are admitted in ICH with MIS-C with two in the PICU; a seven-year-old is on ventilator support.
“Apart from the MIS-C number, the severity also has increased.
Last year about 30% needed intensive care but this year close to 70% need intensive care as they are coming with severe myocarditis requiring cardiac support.
Also some of the classical symptoms of MIS-C are absent in some cases,” said Giri who is also the PICU in-charge at ICH.
While the classical symptoms were fever, redness in the eye and rashes, this time doctors are seeing only fever in some children but absence of the rest that would suggest multisystem inflammation.
“The number could be multiplying in the next few weeks.
So parents need to be aware and keep watch on their children.
If they develop fever four to six weeks after recovery, they should not rule out MIS-C and immediately consult doctors,” said Pal.
With the possibility of a third wave looming large doctors fear a further disproportionate rise in MIS-C cases after the third wave.