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children Washington

11 children in Washington state hospitalized by coronavirus-related syndrome | TheHill – The Hill

Eleven children in Washington state have been diagnosed with a rare condition that is thought to have been triggered by COVID-19 since the beginning of the pandemic.

Four children were diagnosed with the rare disorder — known as multisystem inflammatory syndrome in children (MIS-C) — in May, and seven have developed the illness since then.

Not much is known about MIS-C, but it has been reported to affect the heart, kidneys and gut. Symptoms can include high fever, rash, swelling, abdominal pain, diarrhea and vomiting, John McGuire, chief of critical care at Seattle Children’s told The Seattle Times.

McGuire explained that the condition seems to stem from a haywire immune response after COVID-19 is contracted.

“These kids feel terrible,” the doctor said. “They’re tired, weak, achy, they have pretty high fevers. They feel completely wiped out.”

Fortunately, all of the afflicted children have responded well to treatment, McGuire said.

A report published Friday by the Centers for Disease Control and Prevention revealed 570 children nationally had developed MIS-C as of July 29, resulting in 10 deaths. It has been observed that children have a lower risk of severe complications from COVID-19, and only a tiny percentage have been affected by MIS-C.

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Children and staff at Georgia overnight camp test positive for coronavirus, CDC says – NBC News

A coronavirus outbreak was reported at an overnight summer camp in Georgia that did not require campers to wear face masks.

The Centers for Disease Control and Prevention released a study Friday on the outbreak, saying that it shows children are susceptible to the virus and “play an important role in transmission.”

The camp, which the CDC did not name, held an orientation for 120 staff members and more than 130 trainees in mid-June, according to its Morbidity and Mortality Weekly Report. The staff members stayed at the camp and on June 21 were joined by more than 360 campers ranging in age from 6 to 19.

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Days later, on June 23, a teenage staff member left after developing chills and later tested positive for the coronavirus. The camp began to send people home the following day and alerted the state’s Department of Public Health.

Among the children and staff who were tested for the virus, 260 came back positive, with 231 of them aged 17 or younger.

“Settings, like multi-day, overnight summer camps, pose a unique challenge when it comes to preventing the spread of infectious diseases, considering the amount of time campers and staff members spend in close proximity,” the CDC said in a press release.

The health department recommended that everyone who attended the camp get tested for the virus and self-quarantine. Those who tested positive were asked to isolate. The camp closed down on June 27.

According to the CDC, the camp had everyone submit documentation that they had tested negative for the virus, but did not require campers to wear face masks. Only staff members had to wear masks.

The report also noted that campers slept in cabins and participated “in a variety of indoor and outdoor activities, including daily vigorous singing and cheering.”

“Asymptomatic infection was common and potentially contributed to undetected transmission, as has been previously reported,” the CDC report stated. “This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection and, contrary to early reports, might play an important role in transmission.”

The CDC said in its press release that the proper use of face masks, along with rigorous cleaning and social distancing, can help prevent the spread of the virus. These recommendations are included in the CDC’s recently released guidance for the reopening of schools, which has been under debate as the White House calls for schools to fully reopen.

Image: Minyvonne BurkeMinyvonne Burke

Minyvonne Burke is a breaking news reporter for NBC News.

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'Black children

Black Children Are More Likely to Die After Surgery Than White Peers, Study Shows – The New York Times

Health|Black Children Are More Likely to Die After Surgery Than White Peers, Study Shows

A large study, published in the journal Pediatrics, suggests that disparities exist in surgery outcomes, even among healthy children.

Credit…Christopher Capozziello for The New York Times

Jenny Gross

Black children are more than three times as likely to die within a month of surgery as white children, according to a study published in the journal Pediatrics on Monday.

Disparities in surgical outcomes between Black and white patients have been well established, with researchers attributing some of the difference to higher rates of chronic conditions among Black people. But this study, which looked at data on 172,549 children, highlights the racial disparities in health outcomes even when comparing healthy children.

Researchers found that Black children were 3.4 times as likely to die within a month after surgery and were 1.2 times as likely to develop postoperative complications. The authors performed a retrospective study based on data on children who underwent surgery from 2012 through 2017.

Olubukola Nafiu, the lead author of the study and a pediatric anesthesiologist at Nationwide Children’s Hospital in Columbus, Ohio, said the authors were not surprised to find that healthy children, across the board, had extremely low rates of mortality and rates of complications after surgery. But what surprised them was the magnitude of the difference in mortality and complication rates by race.

“The hypothesis we had when we started was that if you studied a relatively healthy cohort of patients, there shouldn’t be any difference in outcomes,” Dr. Nafiu said.

The authors, in their paper, acknowledged limitations of the study: They did not explore the site of care where patients received their treatments or the insurance status of patients, which can be used as a proxy for socioeconomic status. This meant they could not account for differences in the quality of care that patients received or the economic backgrounds of the patients.

Another limitation was that because mortality and postoperative complications are so uncommon among healthy children, it is possible that most of the cases came from a few hospitals, Dr. Nafiu said.

But while Black people are more likely to receive care in low-performing hospitals, that may not be the main factor driving the gap this study found, Dr. Nafiu said. The hospitals examined in the study were all part of the National Surgical Quality Improvement Program, a voluntary program, meaning they had the resources to be part of the program and the belief that quality improvement is important.

Adil Haider, dean of the medical college at Aga Khan University, who was not involved with the study, said that it told a key piece of the story about racial disparities in surgical outcomes, but that there were still many questions about what drives disparities.

“The real take home is that we just need to start reporting data within hospitals and when we aggregate hospitals — by race and by insurance status — so that we know that, at a given hospital, people from different backgrounds are all receiving the same outcomes,” said Dr. Haider, the former director of the Center for Surgery and Public Health, a joint initiative of Brigham and Women’s Hospital, Harvard Medical School and the Harvard T.H. Chan School of Public Health.

Many studies have shown that people of color receive less and often worse care than white Americans because of reasons including lower rates of health coverage and racial stereotyping.

But one study, published in June by JAMA, suggested some signs of improvement. That research paper, which looked at more than 20,000 extremely preterm infants, suggested that racial disparities in mortality rates had shrunk from 2002 to 2016. The results were significant because the racial disparities around maternal mortality, premature birth and infant mortality have been persistent.

Dr. Nia Heard-Garris, a pediatrician researcher at the Ann & Robert H. Lurie Children’s Hospital of Chicago, who was not involved with the study, said the research was significant because it relied on a large, national sample.

“We’re not talking about one small health system, within one small city, or even one big city — we’re talking about trends nationally,” said Dr. Heard-Garris, who heads the American Academy of Pediatrics’s Section on Minority Healthy, Equity and Inclusion. “As a mom of a Black son who at some point will need surgery, it’s very scary.”

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children School

With Children in School, Study Suggests, Expect Transmission – Newser


(Newser)

We may have been kidding ourselves about the likelihood of children spreading the coronavirus. A major study conducted in South Korea shows that children under 10 do give the virus to each other and to adults less often than other age groups do, the New York Times reports. But it does happen. And particularly worrisome as schools prepare to reopen is the finding that those ages 10 to 19 spread the coronavirus even more often than adults do. This study contradicts some research, but a Harvard expert called the earlier work flawed. The South Korean study, which included contact tracing, “is very carefully done, it’s systematic and looks at a very large population,” he said. “It’s one of the best studies we’ve had to date on this issue.”

One theory for why the youngest spread the virus about half as often as adults is that children exhale closer to the ground, away from adults. And they exhale less air. There are few answers about why older children are so infectious. It might be because they often combine the physical size of adults with the lack of hygiene of young children. “We can speculate all day about this,” one expert said, per the Times, “but we just don’t know.” Even without definitive answers, an epidemiologist said, children would have to be found to not transmit the virus at all for it to be completely safe for them to gather. “Putting them together in schools, having them mix with teachers and other students will provide additional opportunities for the virus to move from person to person,” he said. An infectious disease expert warned: “There will be transmission. What we have to do is accept that now and include that in our plans.” (Read more coronavirus stories.)



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Children with perplexing syndrome linked to covid-19 may be experiencing deadly ‘cytokine storm’ – The Washington Post

The four children showed up at the Mount Sinai Kravis Children’s Hospital in late April and early May, almost exactly one month after the peak of New York City’s coronavirus surge. All had fevers, rashes and strange blood readings that did not look like any illness doctors had seen before. And yet, the cases looked remarkably similar to one another.

A study about the children, ages 13, 12, 10, and 5, published in the American Journal of Emergency Medicine, provides the first detailed look at the rapid progression of a mysterious syndrome linked to covid-19 that has alarmed public health officials.

The Centers for Disease Control and Prevention earlier this month issued an alert warning doctors to be on the lookout for what they are calling multisystem inflammatory syndrome in children, or MIS-C, which is now believed to have impacted approximately 300 U.S. children. It appears to have some characteristics in common with Kawasaki disease, a rare illness that typically impacts children under the age of 5 and whose cause is unknown.

At Mount Sinai, the children, who came through the emergency department, all appeared well initially despite having multi-day fevers. Each complained of different symptoms, but blood tests, imaging and heart monitoring showed they all appeared to be having an exaggerated inflammatory reaction in what doctors suspect is post-viral complication of covid-19.

Christopher Strother, the director of emergency medicine at Mount Sinai, described it as the pediatric version of the “cytokine storm” occurring in some adults with severe illness from the novel coronavirus.

“When adults get covid they might get that terrible lung disease from the inflammatory response,” he said. “This seems a version of how that looks in kids.”

All four children were treated with a drug called tocilizumab to inhibit the inflammatory reaction. The paper’s authors wrote that the “mechanism of injury during cytokine storm is poorly understood, but an exaggerated initial response that persists over time is associated with poor outcomes.”

The first child to arrive at Mount Sinai on Apr. 25 was Malcolm Edgar, a previously healthy 13-year-old from Brooklyn. Edgar, an athlete who is the third baseman and pitcher on a competitive baseball team, had had six days of fever that shot up to 104 degrees. When he woke up on the 25th, he had bloodshot eyes and a rash on the trunk of his body. His tongue had what they described as an odd “strawberry texture.”

At the hospital, doctors ran a battery of tests and his initial vitals seemed fine, except for a slightly elevated heart rate. So they gave him fluids and asked him to wait for the results. Strother recalls that the report he got from the doctor overseeing Malcolm’s care was that “he was walking around the ER eating cheese,” and that “he actually looked quite well.”

But as the night wore on and the nurses kept checking his blood pressure, his readings plummeted. Malcolm himself remembers he was very tired, but not in any pain and that he had been begging to go home.

“I was kind of confused about what was going on,” he said in an interview Thursday. “Everything seemed fine in my checkup, and then they said my blood pressure was low and that’s when everything got crazy.”

Over the next few days, his situation became dire. Imaging showed that he appeared to have pneumonia in both lower lungs, and as he progressed to respiratory failure, he was put on a ventilator.

His mother Ayisha Edgar was at the hospital with him. “I just broke down,” she recalled. “It was very hard for me.”

Blood tests showed markers of inflammation and clotting were off-the-charts elevated. Malcolm’s heart was not working properly, as his arteries showed signs of being enlarged. Meanwhile, three tests doctors gave him for active covid-19 infection came back negative, but an antibody test was positive, indicating he had a prior infection.

His father Sean Edgar, recalled that he and his wife had been sick with mild flu-like symptoms the month before. They lost their sense of taste and smell, but otherwise didn’t think much of their illness. Now they wondered if their son had been infected then, too, although he had showed no symptoms. After Malcolm’s hospital stay, they got tested for covid-19 antibodies and it turned out both had them.

The second patient was a 10-year-old boy who had had a positive covid-19 test 17 days prior. He had come in after five days of fever, diarrhea, cough and a rash all over his body, including his neck, chest, abdomen, back, palms and soles. On his back, there were “dusky areas,” according to the paper.

“[H]e was in no acute distress but complained of general discomfort,” the study’s authors wrote. His fast heart rate and low blood pressure were worrisome, but his breathing was normal. In intensive care, he received blood pressure medication, with an immunoglobulin product that is normally given to patients with Kawasaki disease, and the same immunosuppressant given to the other patients in the study.

The third patient, a 5-year-old boy, had five days of fever, one day of stomach pains and vomiting. He, too, had a rapid heart rate. He was stable for 24 hours until an ultrasound showed he had inflammation in his testicles and thickening gallbladder walls. His blood pressure fell to an emergency-level low of 61/37. In intensive care, the boy also received medication typically used for Kawasaki patients and an anti-inflammatory drug.

The last patient’s case was the mildest. The 12-year-old girl had initially been suspected of having appendicitis. She didn’t have a rash, but after running tests, doctors discovered that her heart was beating super fast — a problem because it means the heart can have trouble filling with blood because it is contracting too rapidly — and her temperature climbed to almost 103 degrees.

All four children have recovered, Strother said, and are back home now.

Malcolm lost 20 pounds in during his 11-day stay the hospital, but did so well after he was off the ventilator that he walked out of the hospital to the cheers of the staff. He’s returned to his school’s Zoom classes and is now strong enough to play some basketball in his backyard and go walk around the local high school track with his dad. He expects to be able to return to playing sports by July.

Sean Edgar says that he would advise other parents who see odd symptoms in their children not to wait: “And if you have to take your child to a hospital, go to a children’s hospital. That was the best choice we made.”

Strother urged doctors who see children with persistent fever to err on the side of caution when monitoring them and ordering tests.

“The trouble is the children look pretty good even when their blood pressure starts to go down,” he said. “You have to be vigilant.”

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children Hospital

Rady Children’s Hospital Confirms First Case of ‘Mystery Illness’ Linked to COVID-19 – NBC 7 San Diego

A Rady Children’s Hospital patient who contracted COVID-19 also tested positive for multisystem inflammatory syndrome in children (MIS-C), a rare disease being investigated for its connection to the novel coronavirus in children.

MIS-C, formerly called Pediatric Inflammatory Multisystem Syndrome (PIMS), has been described by medical experts as a “mystery” illness linked to COVID-19.

A spike in MIS-C cases corresponded with a rise in novel coronavirus infections at the onset of the pandemic, leading doctors around the nation to test MIS-C patients for coronavirus antibodies which could signify they had contracted that virus first.

Local

A spokesperson for Rady Children’s said a 6-year-old COVID-19 patient contracted MIS-C. It’s the first and only MIS-C case at the facility so far, the spokesperson said.

While there are no cases of COVID-19 linked to Kawasaki Disease or PIMS Disease, the county health department is aware and on the lookout. NBC 7’s Alexis Rivas reports.

The child was admitted late last week and had already been released by Thursday afternoon, according to the spokesperson.

The Centers for Disease Control and Prevention issued a health alert to physicians in mid-May about the deadly disease that has appeared in multiple states and claimed the lives of children as young as 5 and as old as 18.

Doctors and researchers across the country believe MIS-C and COVID-19 are somehow linked, but are still trying to uncover evidence solidifying their connection.

Now that MIS-C is garnering more attention from medical experts, Rady Children’s said they are examining COVID-19 cases that have come through their facility to see if the patients also had MIS-C, the spokesperson said.

Doctors who’ve treated MIS-C cases have said the illness mirrors many of the symptoms of Kawasaki disease which researchers are also investigating for its possible connection to COVID-19 in children.

“What we need is information,” Dr. Adiana Tremoulet, associate director of the Kawasaki Research Center at Rady Children’s Hospital, told NBC 7 earlier this month. “What we don’t need is fear right now.”

A California baby was the first patient linking COVID-19 to Kawasaki disease, according to the San Francisco Chronicle

MIS-C and Kawasaki disease are hyper-inflammatory diseases that can affect children of any age and, if left untreated, can trigger heart failure.

The CDC’s alert underscores how little researchers still know about the coronavirus — just months ago, health experts said it didn’t affect children. 

“There may be a link there with the virus both with general Kawasaki disease as well as [MIS-C],” says Tremoulet.

Tremoulet says many children in the hospital with MIS-C were exposed to family members infected with COVID-19.

“We’re certainly not trying to sound the alarm,” Tremoulet said. “We’re just trying to educate so our families know when they should seek medical attention.”

Kawasaki symptoms include fever, rash, red-eye, swollen hands and feet, and red lips and tongue. MIS-C is similar, but can also include severe abdominal pain and low blood pressure.

NBC New York’s Melissa Russo reports.

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Dozens more children hospitalized in New York with rare symptoms that could be linked to coronavirus – CNN

(CNN)A growing number of children are showing up at New York hospitals with troubling new symptoms that state health officials believe could be linked to coronavirus.

In an advisory to health care providers, state officials said 64 children in New York have been hospitalized with a condition doctors described as “pediatric multisystem inflammatory syndrome.”
New York City had alerted Monday that 15 patients between ages 2 to 15 were hospitalized over the past three weeks with the Covid-related syndrome. Most of them tested positive for coronavirus or had positive antibody tests.

The symptoms to watch for

Some of the children had persistent fever, toxic shock syndrome and features similar to Kawasaki disease, the state health advisory said.
Kawasaki disease causes inflammation in the walls of the arteries and can limit blood flow to the heart. While it’s usually treatable and most children recover without serious problems, it can also be deadly. It mainly affects children under age 5.
Symptoms include a high temperature lasting over five days along with a rash, swollen neck glands, dry cracked lips, swelling of the hands and feet, and redness in both eyes.
Kawasaki is a leading cause of acquired heart disease in the United States, with complications that include coronary artery enlargement and aneurysms, according to the Centers for Disease Control and Prevention.
While older adults are mostly at risk for severe coronavirus, children can also get infected, health officials said.
The new syndrome has appeared in children elsewhere. Seattle has also reported a case along with a team at Stanford Children’s Hospital in California.
In the UK, pediatric specialists recently warned that a small number of children was becoming ill with the rare syndrome that could be linked to coronavirus. Experts there said abdominal pain, gastrointestinal symptoms and cardiac inflammation are common in those cases.
Similar cases have been reported in Italy and Spain.

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