Valley Children's doctors brace for a rise in rare pediatric condition following Delta surge

Sep 17, 2021

Six-year-old Bryce Moore shouts from one side of the small soccer field where he is practicing for his first game. His mom, Fresno resident Jennifer Moore, describes him as a happy, go-lucky kid. But nine months ago he was anything but that, she says. 

Moore and her husband tested positive for COVID-19 in November 2020. She says Bryce, then 5 years old, tested negative and didn’t show any symptoms associated with the virus. 

“My husband and I got through that and recovered,” she says. “Then at the end of January, we picked him up from school on a Friday, and he had a little bit of a headache.”

That was nearly two months after she and her husband contracted COVID-19. When Bryce woke up the next morning, his headache was worse. He developed a fever, refused to eat and on Sunday, she says, he could barely walk. So she reached out to Kaiser Permanente’s advice line. 

“They got us a video appointment and saw him,” Moore says. “They were concerned he had meningitis.” 

Moore rushed him to Valley Children’s hospital where, she says, the doctors ruled out meningitis. The doctors sent them home but two days later, Bryce was still in a lot of pain, with a fever, bloodshot eyes and a growing rash on his back, she says.

“It was quite difficult to see him go through that,” Moore says. 

  It took two more visits to the emergency room before doctors finally asked Moore if Bryce had been exposed to COVID-19 in the last few months. 

“Through that it came up that my husband and I had COVID and it was like it clicked right away,” she says. “They knew exactly what it was.” 

Doctors diagnosed Bryce with Multi Inflammatory Syndrome in children, or MIS-C. It’s a post-infectious phenomenon that is occurring in children, according to Dr. Reshma Patel, a pediatric rheumatologist at Valley Children’s Hospital. 

“It is not a disease or syndrome itself,” Patel explains. “It is essentially what I like to call a tornado or cascade of events that's happening when the immune system is on overdrive.”

MIS-C cases tend to increase following a spike in COVID-19 cases, according to the Centers for Disease Control and Prevention. That’s why, as schools reopen amid a surge driven by the Delta variant, Patel says, she’s been working to educate pediatricians across the state on how to identify and treat MIS-C.

“We are seeing a big surge in the Delta variant and rising COVID-19 infection cases now,,” Patel says. And so we are bracing ourselves for a MIS-C surge soon to follow.”

The symptoms of MIS-C include fever, headaches, neck pain, redness of the eyes, lips, mouth, hands and sometimes even vomiting and diarrhea. Because it’s a new phenomenon, doctors have a hard time diagnosing it, she says, but the most obvious sign is if a child has these symptoms and has been exposed to COVID-19. 

“And it is occurring about two to eight weeks after the initial COVID has been present in that child,” she says.

There were nearly 5,000 reported cases of MIS-C and 41 related deaths in the nation, as of Aug. 27, the CDC said. That included nearly 600 cases in California. The Fresno County Department of Public Health did not have data on local cases and referred KVPR to Valley Children’s Hospital. Patel says the data is currently unavailable due to a “failure of reporting” but the hospital is addressing the issue.    

While MIS-C is considered fairly rare, it is disproportionately hitting Black and Latinx children. Dr. Erik Fernandez y Garcia, an associate professor of clinical pediatrics at UC Davis, says crowded housing and other factors could explain this overrepresentation.   

“Black and Latinx workers tend to work in locations and in jobs where there is more frequent contact with people,” he says.

And given the number of COVID-19 cases in the Central Valley, Jennifer Moore says she’s concerned about Bryce’s health as he enters kindergarten.

 "There is that fear there, because I know we do our best to stay safe,” she says. “But we don't always know what everybody else is doing. But I also want him to be a kid.”

That’s why she also urges parents to take the virus seriously and follow CDC guidelines until a vaccine is available for kids younger than 12.

“They may not get COVID directly, but that doesn't mean it can't affect them in other ways,” she says.

These days, Bryce is back to playing soccer with his neighborhood friends. But his mom says that because the long-term effects of MIS-C are still unknown, doctors will continue monitoring his health.

This story is part of the Central Valley News Collaborative, which is supported by the Central Valley Community Foundation with technology and training support by Microsoft Corp.