This 2020 electron microscope made available by the U.S. Centers for Disease Control and Prevention image shows the spherical coronavirus particles from the first U.S. case of COVID-19. The Canadian Paediatric Society is closely monitoring reports of an inflammatory syndrome among some kids also diagnosed with COVID-19.THE CANADIAN PRESS/AP-C.S. Goldsmith, A. Tamin/ CDC via AP

Canadian Paediatric Society eyes mysterious syndrome for suspected COVID links

Symptoms of Kawasaki disease include dark red rashes that come and go, high fever, and swelling in the palms and feet

The Canadian Paediatric Society is closely monitoring reports that COVID-19 may be linked to a strange inflammatory syndrome in some children.

The society says it expects to issue advice to clinicians late this week or early next about symptoms similar to Kawasaki disease, although a COVID-19 connection has not been established.

A broad study is underway with the Canadian Paediatric Surveillance Program to detect how, and how many, children are being severely affected by COVID-19. A spokeswoman says that would include any cases that suggest Kawasaki disease, the primary cause of acquired heart disease among children.

Symptoms of Kawasaki disease include dark red rashes that come and go, high fever, and swelling in the palms and in soles of the feet. Patients can also develop lymph nodes on the neck, and inflammatory markers in the blood.

An infectious diseases pediatrician at Sainte-Justine Hospital in Montreal says COVID-19 is believed to be a factor in more than a dozen cases of Kawasaki-like illness there.

Dr. Fatima Kakkar says the cases emerged over the last three to four weeks and that it’s unusual to see so many within that time period.

None of the kids tested positive for an active COVID-19 illness, but because Kawasaki is believed to be triggered by a viral infection, she says doctors suspect there may have been a past COVID infection that was never detected.

Typically, Kawasaki disease cases emerge once every two weeks at most, Kakkar added.

“Thanks to the containment and social isolation (measures), there are no other viruses circulating,” Kakkar said Wednesday.

“We definitely don’t want to make the 100-per-cent link because we don’t have that proof yet, but it is suspicious. And I think with the other countries coming up with their data, it does raise the fact that the most likely virus circulating right now is actually COVID.”

ALSO READ: British Columbians can double their ‘pandemic bubble’ mid-May, but no large gatherings

Similar cases have been reported in the United States and Europe. This week, New York City’s health department issued an alert about 15 cases, and stressed that early recognition and specialist referral was “essential.”

Kakkar says she and her colleagues must now determine whether the patients — who range in age from one year to late teens and have all recovered — had a past COVID-19 infection, but antibody tests are not yet available in Canada.

She says efforts are underway to get a clinical test validated, or test the children as part of a research protocol.

“These kids would have had to have had their infections weeks ago, cleared the infection, and now it would be the body’s immune system sort of hyper-responding to the infection,” Kakkar guesses.

“The closest we’ve come to identifying COVID is when we see that, for example, the child’s negative but the parents are COVID-positive.”

Canada’s chief public health officer also addressed the issue Wednesday, cautioning parents that children with COVID-19 have mild symptoms and that severe outcomes are very unusual.

Still, Dr. Theresa Tam said parents who are concerned should contact their health-care provider.

“Pediatricians are very aware of Kawasaki disease because it actually happens with other viral illnesses and infections as well. So it’s not specific to COVID-19 and they would know how to manage that.”

The questions arise while much of Quebec prepares to gradually reopen daycare and elementary schools Monday, with the Greater Montreal area set to reopen May 19.

But Kakkar suggested the emerging mystery around Kawasaki-like symptoms is not enough to derail those plans.

“Compared to the numbers of kids who’ve had COVID, this is a very rare complication,” says Kakkar.

Kawasaki is diagnosed through a combination of clinical signs and blood markers, with a set number of criteria that define classic symptoms.

The suspicious patients are considered “atypical Kawasaki” cases because they have some, but not all of the criteria, says Kakkar.

That includes the fact many are older, when Kawasaki typically strikes before age 6.

“That’s what puzzled us on the wards the last few weeks,” she says. “It is important for all the other doctors and the parents to be aware of these bizarre symptoms.”

Like COVID-19, there is still much to learn about Kawasaki disease, she adds.

“We think it’s a viral or a bacterial trigger, but we don’t really know — is it something genetic? Is there an immune trigger? Is there something that’s changed in the environment? We don’t know.”

Cassandra Szklarski, The Canadian Press


@katslepian

katya.slepian@bpdigital.ca

Like us on Facebook and follow us on Twitter.

CanadaCoronavirus

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Comments are closed

Just Posted

Three face charges in Nelson fentanyl busts

Two men and a woman were arrested in two separate incidents

Milestone RCMP Cops For Kids fundraiser ride going virtual

You can join and help RCMP raise funds for families and possibly win 20th anniversary cycling shirt

Nelson cyclist run over by truck

Driver ticketed for failing to yield right of way on left turn

Hwy 1 flooding causes massive delays on certain Arrow Lakes ferry routes

Motorists have been waiting around three hours to get on ferries

RDCK: spring flooding financial relief available

The provincial funds are for those affected by flooding in May and early June

B.C. accommodators need phone lines to light up as in-province travel given green light

Travel restrictions during the COVID-19 pandemic have decimated the tourism and hospitality industries

300 Cache Creek residents on evacuation alert due to flood risk as river rises

Heavy rainfall on Canada Day has river rising steadily, threatening 175 properties

First glimpse of Canada’s true COVID-19 infection rate expected mid-July

At least 105,000 Canadians have tested positive for COVID-19 since the coronavirus was identified

Police ramp up efforts to get impaired drivers off B.C. roads this summer

July is dedicated to the Summer CounterAttack Impaired Driving Campaign

Migrant workers stage multi-city action for full status amid COVID-19 risks

‘COVID-19 has exacerbated an existing crisis’

Okanagan school drops ‘Rebels’ sports team name, citing links with U.S. Civil War

Name and formerly-used images “fly in the face” of the district’s human rights policy, says board chair

PHOTOS: B.C.’s top doc picks up personalized Fluevog shoes, tours mural exhibition

Murals of Gratitude exhibit includes at least one portrait of Henry alongside paintings of health-care workers

In troubled times: Independence Day in a land of confusion

Buffeted by invisible forces and just plain worn out, the United States of America celebrates its 244th birthday

Stop enforcing sex work laws during COVID-19, advocates say

There are provisions in Canada’s prostitution laws that make workers immune from prosecution, but not from arrest

Most Read