Questions swirl in Florida on the impact of children’s illness tied to coronavirus

How long has it been attacking children?
A boy wearing a mask looks behind him next to Meridian Hill Park in Washington on Friday.
A boy wearing a mask looks behind him next to Meridian Hill Park in Washington on Friday. [ ANDREW HARNIK | AP ]
Published May 22, 2020

Florida has a growing number of children with a COVID-19 related illness, but how long it has been attacking children and the number of pediatric patients who have been treated remains a mystery.

Florida Department of Health officials won’t say how many suspected or confirmed cases of “multisystem inflammatory syndrome in children,” or MIS-C, have been reported to county health departments. They have not replied to email inquiries since state Surgeon General Scott Rivkees confirmed Monday that Florida was “beginning to see a few cases.”

Wolfson Children's Hospital in Jacksonville has two patients with confirmed cases of MIS-C.

But Mobeen Rathore, a physician and chief of the University of Florida Division of Pediatric Infectious Diseases and Immunology, said 12 patients in the Jacksonville area have been treated at Wolfson since mid-April who are now suspected to have had MIS-C.

“This is an evolving situation. Our first cases, they weren’t even called MIS-C at that time.” Rathore, who practices at Wolfson, told The News Service of Florida on Thursday.

Six-year-old Ezra Somnitz is one of those patients. Ezra was hospitalized at Wolfson for four days last month for what was then a mysterious illness that reddened the whites of his eyes and spiked his temperature. His skin was so inflamed that one of his feet doubled in size and turned purple.

When he was discharged from the hospital, the official diagnosis was toxic-shock syndrome, his mother, Melanie, said. But that was before the federal Centers for Disease Control and Prevention sent out a health advisory to physicians last week detailing the emergence of MIS-C in New York City and New York state, which had an estimated 102 cases as of May 12.

The pediatric infectious disease specialists at the University of Florida who are treating her son called Melanie Somnitz last week asking that she have serological testing done to confirm the MIS-C diagnosis.

“He fits. Literally go down the checklist, and he has all the things except for the COVID antibody test. He had the red eyes, the high fever, the rash, negative COVID tests, diarrhea and vomiting,” Somnitz said, adding, “he was admitted to the PICU (pediatric intensive care unit) for five days.”

MIS-C manifests in people under age 21 who are positive for COVID-19 or have antigens or have been exposed to COVID-19 in the four weeks prior to the onset of symptoms, according to the Centers for Disease Control and Prevention. The symptoms include fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck and irritation and inflammation of the mouth, lips and throat.

Rathore said physicians had never heard the term “MIS-C” two months ago. Now, he said, physicians and hospitals across the state are treating patients.

“I know there are cases all over Florida and all over the United States,” Rathore said.

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While the state Department of Health has not commented on the numbers of cases, Rathore said Florida might not have the data yet. He noted that physicians and hospitals weren’t told to report the data to the state until this week.

Three Southeast Florida children’s hospitals have six confirmed MIS-C cases, with two cases at Holtz Children’s Hospital in Miami, two at Nicklaus Children’s Hospital in Miami and two at Joe DiMaggio Children’s Hospital in Hollywood, representatives of the facilities told The News Service of Florida.

But not all children's hospitals in Florida say they have MIS-C patients or have seen suspected cases.

“This is not something we're seeing.” Alayna Curry, a spokeswoman for Arnold Palmer Hospital for Children in Orlando, told the News Service.

All Children’s Hospital in St. Petersburg said Tuesday it had no definitive cases. It did not respond to follow-up inquiries Thursday.

It’s been about a month since Ezra was released from the hospital, and Melanie Somnitz said he’s doing better.

“He's still taking a nap every day, he’s still really worn out,” said Somnitz, who has three other children. “His foot is normal now, but you can see where it’s dry, where it swelled real big.”

But it’s not the short term that she’s worried about. She said she worries about the long-term effects MIS-C will have on her son, who developed a heart murmur after his illness in April.

Though this emerging MIS-C presents another new scare associated with COVID-19, Rathore said parents need to be informed but not worried.

“I think they need to use the usual parental common-sense skills that we all as parents do,” Rathore said. “Look at the kid. And if your kid looks sick, call your pediatrician and let the pediatrician advise you. If your kid looks very sick and you take them to the emergency department, we are ready and prepared to take care of your children.”

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