In Depth

Why everyone’s talking about Kawasaki disease

Coronavirus thought to be triggering deaths in children from rare inflammatory syndrome

Children in the UK with no underlying health conditions have died of a rare inflammatory syndrome believed to be linked to coronavirus, the government has confirmed.

Health Secretary Matt Hancock says that while cases of Kawasaki disease are rare, the outbreak is “something that we’re worried about”, says Sky News.

What is the condition?

According to a report in the Health Service Journal, an “urgent alert” was sent out to GPs in London in the past few weeks. It warned of “an apparent rise in the number of children of all ages presenting with a multisystem inflammatory state requiring intensive care”.

The alert sent to GPs says that “there is a growing concern that a [Covid-19] related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases”.

The message adds: “The cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe Covid-19 in children.”

Typical symptoms of this condition include stomach pain, cardiac inflammation and “gastrointestinal symptoms” – which could include vomiting and diarrhoea.

Two of the most common symptoms of Kawasaki disease include a rash and a fever, while toxic shock syndrome causes a rash, dizziness and diarrhoea.

A separate alert, sent out by the Paediatric Intensive Care Society, urges doctors to “please refer children presenting with these symptoms as a matter of urgency”.

The NHS says that characteristic symptoms are a high temperature, of 38C or above, that lasts for five days or more, with:

  • a rash
  • swollen glands in the neck
  • dry, cracked lips
  • red fingers or toes
  • red eyes

The rash is typically (but not always) on the chest, says Great Ormond Street Hospital.

“Palms of the hands and soles of the feet turn bright red, become puffy and the skin can peel,” adds GOSH, and children can experience “redness on the insides of the eyelids, lips tongue and inside the mouth”.

How dangerous is it?

The Sun reports that NHS England has not yet confirmed a “link between Covid-19 and Kawasaki-like diseases”, adding that “advice to parents hasn’t changed”.

But Hancock told LBC Radio: “There are some children who have died who didn’t have underlying health conditions.

“It’s a new disease that we think may be caused by coronavirus and the Covid-19 virus. We’re not 100% sure – because some of the people who got it hadn’t tested positive – so we’re doing a lot of research now but it is something that we’re worried about.

“It is rare – although it is very significant for those children who do get it, the number of cases is small,” reports Metro.

The NHS says Kawasaki disease is always treated in hospital, and the “sooner treatment starts, the quicker the recovery time and there’s less risk of complications developing”.

Around 25% of children with Kawasaki disease experience complications with their heart.

If the condition is untreated, complications can be fatal in around 2-3% of cases.

Professor Anne Marie Rafferty, president of the Royal College of Nursing, said she had heard of similarities between the emerging inflammatory disease and Kawasaki syndrome, says Metro.

“Actually, there’s far too little known about it and the numbers actually at the moment are really too small,” she said. “But it is an alert, and it’s something that’s actually being explored and examined by a number of different researchers.”

Professor Simon Kenny, NHS national clinical director for children and young people, said: “Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to Covid-19.

“But it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast.”

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