Two weeks ago, I wrote about Pediatric Multisystem Inflammatory Disease. A lot has changed since then.

The most obvious change is the name. The new name as certified by the Center for Disease Control(CDC) is Multisystem Inflammatory Disease in Children known as MIS-C. The other revelation from the CDC is the formal criteria for making this diagnosis.

There was a time that any of us could pick up a New York newspaper and read that there were several hundred cases of MIS-C being reported setting off a panic for anyone that has young children. What was being missed are terms like “being reported” and “being accepted” by the State Board of Health. Since the State Board of Health adopted the CDC criteria for MIS-C, the terms “submitted” to the Health Department and “accepted” by the Health Department have been widely divergent.

In New Jersey, while many cases have been submitted to the state Health Department, as of Friday May 29th, 26 cases in the entire state of New Jersey between 1 and 18 years of age have been accepted and perhaps most importantly, there have been no deaths. Out of those 26 cases that have been accepted, only 18 have tested positive for COVID-19 or COVID-19 antibodies. This means, that by strict CDC interpretation, only 18 children between the ages of 1 and 18 have met the absolute criteria for MIS-C in New Jersey. In New York State, as of Friday May 29th, there have been confirmed and accepted 124 cases of MIS-C. Three children have been reported to have passed away, though it is unclear whether any of these children were part of the 124 cases of accepted MIS-C children or were part of the submitted cases of MIS-C, which means they may have died of other causes. Obviously, while one case of MIS-C in a child is one case too many, it is clear that the number of MIS-C cases in children is a mere fraction of the total number of COVID-19 cases in New Jersey and New York.

One of the common questions asked, is whether MIS-C is contagious? This is an evolving question and there is no clear answer. However, logically it should not be. With MIS-C, the virus should be gone and replaced by an immunologic response, and it is this response that creates MIS-C. This is what creates the antibody response and the symptoms. The child even if COVID-19 positive should not be contagious. This is important information as the children return to school. I will however place an asterisk next to this statement, because what is theoretical has not been proven to be true. There are sure to be updates in this area. I will remind everyone in contrast to MIS-C however, that while children are rarely symptomatic from an acquired COVID-19 infection, they are quite able to pass COVID-19 on to others both children and adults.

This MIS-C diagnosis is a rapidly evolving situation. The diagnosis itself is barely a month old. I remember treating my first child with MIS-C during the first weekend in May. There was no name and only a few case reports from Europe. Now, as May ends, there is a formal name and diagnostic criteria from the CDC which has drastically lowered the number of true cases of MIS-C. The Hackensack Meridian Healthcare System lead by Jersey Shore University Medical Center and Hackensack University Medical Center have developed a joint task force to study and report on the best modes of treatment for these children. There is a great deal to learn, and no doubt new revelations to be discovered, so stay tuned.

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Mitchel B. Alpert, M.D., FACC,FAAP

Director of Pediatric Cardiology

K. Hovnanian Children’s Hospital

Jersey Shore University Medical Center

Hackensack Meridian Health