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

Just Posted

Cops For Kids ride wraps in Okanagan

No pomp, no circumstance for end of milestone 20th anniversary fundraising bicycle trip

Former Kelowna cop faces fourth lawsuit alleging sexual assault

Ex-Mountie Brian Mathew Burkett is also separately facing seven charges of breach of trust

QUIZ: A celebration of apples

September is the start of the apple harvest

Smoky skies clearing throughout B.C. Interior

Environment Canada expects “widespread” improvement for all affected areas by Sunday

B.C. or Ontario? Residential school survivors fight move of court battle

It’s now up to Ontario’s Court of Appeal to sort out the venue question

B.C. transportation minister will not seek re-election

Claire Trevena has held the position since 2017

Squabble over mask policy at LUSH in Kelowna mall

The woman filmed the encounter at LUSH Cosmetics, where wearing a mask in-store is company policy

Province opens ‘middle income’ housing in Kelowna

Prices on the units are $1,300 for a one-bedroom and $1,780 for a two-bedroom, nearing area-average prices

Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Young B.C. cancer survivor rides 105-km with Terry Fox’s brother

Jacob Bredenhof and Darrell Fox’s cycling trek raises almost $90,000 for cancer research

B.C. migrant, undocumented workers rally for permanent residency program

Rally is part of the Amnesty for Undocumented Workers Campaign led by the Migrant Workers Centre

Reward offered for return of Okanagan puppy

An 11-week-old boxer-mastiff cross pup was allegedly taken from its Kelowna Friday, Sept. 18

Preparations underway for pandemic election in Saskatchewan and maybe B.C.

Administrators in B.C. and around the country are also looking to expand voting by mail during the pandemic

Most Read