Two cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in Washington state

Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Health officials do not yet know what causes MIS-C, however, they do know that many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.

May 22, 2020, OLYMPIA – The Washington State Department of Health (DOH), Snohomish Health District and Public Health—Seattle & King County are confirming two cases of Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19.

The patients, one Snohomish County resident and one King County resident, both received treatment at Seattle Children’s Hospital. One patient is under the age of 10 and the other is between 10 and 19 years of age.

These are the only cases reported in Washington state residents to date. Health care providers in the United Kingdom were the first to recognize cases in late April, and providers in other states have identified cases as well. Following increased reports of previously healthy children presenting with a severe inflammatory syndrome with Kawasaki disease-like symptoms, the Centers for Disease Control and Prevention (CDC) issued a health advisory last Thursday with a case definition.

“In Washington, we are tracking this issue closely and working with local health departments and providers to learn more,” said Dr. Kathy Lofy, state health officer for DOH. “Early last week we asked all health care providers in the state to be on the lookout and immediately report possible cases to local health authorities.”

The current case definition includes the following:

• Under the age of 21, with a fever, laboratory evidence of inflammation, and severe illness involving more than two organs that requires hospitalization; AND
• No other plausible diagnoses; AND
• Positive COVID-19 test, or exposure to a confirmed case, within the four weeks prior to the onset of symptoms.

“Seattle Children’s is committed to caring for our region’s most medically complex children, and our team of specialists is well-equipped to care for children presenting with this newly identified syndrome,” said Dr. John McGuire, Chief of the Division of Pediatric Critical Care Medicine at Seattle Children’s. “Although it remains very uncommon, parents should call their primary care providers if their children are showing new or unusual symptoms, such as a persistent fever or headache, abdominal pain with or without diarrhea, fatigue, and respiratory symptoms such as shortness of breath.”

“Parents who have concerns about possible COVID-19 in their children should contact their healthcare provider promptly,” said Dr. Jeff Duchin, Health Officer for Public Health – Seattle & King County. “Identifying this syndrome early is important because treatments are available for the serious complications.”

“While the vast majority of children appear to have mild or asymptomatic infection, it’s important to remember that—although rare—some children can develop serious complications like these,” said Dr. Chris Spitters, health officer for the Snohomish Health District. “Our thoughts are with the young patient, their family and the care team at Seattle Children’s, and we wish for a speedy recovery.”

Given privacy concerns, public health officials will not release additional information on these cases.

Healthcare providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local public health agency. Additional guidance for pediatric healthcare providers was issued by CDC on May 15.

For more information on COVID-19, visit the Department of Health’s website or call 1-800-525-0127. More information on MIS-C and COVID-19 is also available from Seattle Children’s Hospital, Snohomish County Health District , Public Health – Seattle & King County and the Centers for Disease Control and Prevention