SA Health alert over rare, but serious, Covid-19 complication in children

An urgent health alert has been issued after a rare, but dangerous, Covid-linked condition was found in South Australian children for the first time. Here’s what to look out for.

The best way to avoid the complication was to get children vaccinated, an SA Health alert warned. Picture: Brendan Radke

SA Health has issued an urgent public alert after a rare, but dangerous, Covid-linked condition was found in South Australian children for the first time.

In a warning to the state’s doctors, Covid chiefs revealed two young patients were recently identified with Paediatric Inflammatory Multisystem Syndrome, or PIMS-TS.

Medical experts say the serious complication, also called Multisystem Inflammatory Syndrome in Children, is a mysterious hyper-inflammatory state in youngsters who have been infected with coronavirus.

Symptoms can include fever, abdominal pain, gastrointestinal issues such as vomiting and diarrhoea, rash, irritability, red eyes or shock caused by low blood pressure.

Presentation, which can be delayed by up to six weeks after an infection, is similar to acute appendicitis.

Having been detected in the United States, Britain and Europe, signs and symptoms vary, as does the severity but doctors should be mindful if symptoms persist for more than three days.

While incredibly rare – fewer than one per cent of children develop the condition – serious cases require intensive care treatment while deaths have been recorded overseas.

In its public health alert, issued late on Tuesday to all of the state’s medical practitioners, the Communicable Disease Control Branch said it emerged in areas with “high incidence of acute … infection”.

No further details were released about the SA paediatric patients including their ages, when they developed the complications or if they needed ICU treatment.

But the branch’s Covid-19 operations director, Dr Ann Koehler, said the median age of patients around the world was nine years-old but it has also been reported in infants and teenagers.

“Although it may be concurrent with acute Covid-19, PIMS-TS usually occurs two to six weeks after infection … even if this was asymptomatic or mild,” Dr Koehler wrote.

“By which time PCR (lab) tests are usually negative, so these are not useful in diagnosis.

“Early studies in children and adolescents suggest that vaccination with two doses of an mRNA vaccine may reduce the risk of children developing PIMS-TS.”

She added: “Cardiac involvement is common, and in more severe cases … ICU admission has been required.

“Coronary artery aneurisms occur in approximately 15 per cent. Deaths have been reported.

“Serious bacterial infection remains the most common cause of fever and shock in children presenting for emergency medical care.”

Figures show almost 40 per cent of the state’s current cases are children or teens younger than 18 while just 55 per cent of kids aged five to 11 are vaccinated.

Last year, the country’s emergency medical expert panel, the Australian Health Protection Principal Committee told national cabinet the condition had features that overlap with Kawasaki disease (KD) and Toxic Shock Syndrome (TSS). Kawasaki disease affects between 200 and 300 children each year in Australia.