Sarah Zhang: It was clear pretty early on that kids don’t seem to get very sick from the virus. And when they do, they’re often asymptomatic or very mild, and it also seems like they don’t really spread it. But a few weeks after the virus first peaked in New York, doctors started noticing, as Liz says, this Kawasaki-like disease, which is now called multisystem inflammatory syndrome in children, or MIS-C. When I was reporting on it back in May, it had a different name, but I guess they settled on MIS-C.
Wells: It seems like it’s just “miscellaneous.”
James Hamblin: It is the perfect word, actually. I don’t mean to make light of this—because it can be very serious and I’m sure that wasn’t unintentional—but it fits really well.
Wells: Okay, so this miscellaneous syndrome affects children. Sarah, what is it?
Zhang: Well, it’s fittingly a miscellaneous set of symptoms. It includes a bunch of different things that are usually seen with an overactive immune system, like rashes on the palms of your hands and the soles of your feet, a swollen tongue, cracked lips, in some cases really, really low blood pressure. It looks like a bunch of different things that can sometimes happen with different viruses as well. Kids sometimes just have what looks like an overactive immune system. They have almost a delayed reaction to the virus.
Part of the reason this took a while for doctors to notice is that it seemed to peak about six weeks after the COVID-19 cases actually peaked in New York. It seems like there was some delay between exposure and actually getting this syndrome. That’s why it took so long to notice. It’s also because it’s really, really rare.
Hamblin: I think part of the reason we haven’t heard more about it is because it’s so difficult to define and because of that lag. That is why you’re just now seeing these clear cases. The CDC has warned parents to consult a doctor “right away” if their child develops “symptoms of MIS-C” that include “fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eye, [or] feeling extra tired.”
And there have been fatalities. Some kids have had serious cases. So essentially, CDC was telling people: Hey, if you don’t have enough to worry about already, if it seems like your kid is feeling extra tired, they might have this serious condition.
Zhang: As you’re saying, it’s this collection of symptoms that are so nonspecific. Part of the worry is that we really don’t know why most kids are totally fine after getting COVID-19 but a very, very small number seem to develop this serious condition. And that kind of uncertainty, of knowing this can happen but not knowing who it will happen in, makes it really hard.
Wells: So this is happening to kids after they have recovered from COVID-19?
Hamblin: They probably didn’t even get it.