Bahk Eun-ji has been with The Korea Times since 2012, building a career across multiple desks. She began at the Business Desk, where she conducted in-depth interviews with key figures in Korea's corporate world. Later, she moved to the Politics & City Desk, focusing on education policy and social affairs. She later served as team leader of the digital content team, leading curation efforts on the newspaper’s homepage and reshaping print stories for social media audiences to enhance digital reach. Now back on the Politics Desk, she covers the National Assembly and the Ministry of National Defense, with a renewed focus on political developments.
What to know about MIS-C
Elementary school students wearing masks go to school with their parents in Seoul, in this Sept. 24 photo. Korea Times photo by Bae Woo-han
By Bahk Eun-ji
By Bahk Eun-ji
Nearly 25,000 people in Korea have tested positive for COVID-19 since the coronavirus pandemic started, but there is another health threat primarily affecting children
On Oct.5, the health authorities here officially confirmed the first two cases of Multisystem Inflammatory Syndrome in Children (MIS-C) ― 11- and 12-year-old boys. MIS-C is a rare but severe condition that manifests about two to four weeks after the onset of COVID-19 in children.
The cause of MIS-C has not been identified yet, so it has been called a “mysterious illness.” As research and data build up, the characteristics of the illness are gradually being revealed. Here is some information about the syndrome mainly based on recent research.
Causes and symptoms
MIS-C presents symptoms of inflammation in various parts of the body, such as the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. It appears to occur mainly in those aged under 19.
It was formerly called pediatric inflammatory multisystem syndrome, or PIMS, describing a new health condition seen in children who had been infected with the coronavirus and recovered from it, only later to have an immune response that resulted in significant levels of inflammation in the body's organs.
The prominent symptoms include fever or rash, non-purulent conjunctivitis or skin mucosa inflammation, hypotension or shock, myocardial dysfunction, coagulation disorder, and acute gastrointestinal disorders.
Since it was first reported in countries in Europe in April, more than 100 children have died, mainly in Europe and the United States. The World Health Organization (WHO) estimates that the syndrome in children and adolescents is possibly related to the coronavirus infection.
How serious is the domestic situation?
It has been officially confirmed that two young COVID-19 patients in Korea have developed MIS-C. The two boys have been discharged without complications as their symptoms have improved. There were also suspected cases in Korea in May, but at the time, it was found to be unrelated to COVID-19. According to the KDCA, a total of seven suspected cases have been reported so far, with only two of them confirmed as MIS-C.
The quarantine authorities believe that the occurrence of the syndrome in children and adolescents is rare in Korea because the level of the COVID-19 outbreak is relatively low compared to that in Europe and the United States.
As of Oct.7, 1,928 infections in those under the age of 20 (1,334 teenagers, 594 under the age of nine) have been reported. One younger child and one adolescent with MIS-C were not initially classified as COVID-19 patients, but both were infected with the virus. Of the 1,928 cases under the age of 20, two patients with MIS-C which accounted for 0.1 percent here.
In other words, it can be predicted that as the number of confirmed cases in those under the age of 20 increases by 1,000, one person will suffer from the rare syndrome.
In the United States, where the number of COVID-19 infections is increasing exponentially, as of Oct.1, 1,027 cases were reported to have the syndrome, of whom 20 have died. The 1,027 cases accounted for 0.013 percent of the total 7.72 million confirmed cases in the U.S. as of Oct.7 according to data compiled by World-o-meter. In France and the U.K., 79 and 78 have been reported, respectively, with 1 and 2 deaths respectively as of Oct.5.
Kim Woo-joo, a professor of infectious disease at Korea University's Guro Hospital, warned, “In Korea, an increasing number of confirmed cases can lead to a large number of cases of MIS-C, and deaths from complications as in the U.S. We should not be relieved that infants and adolescents are safe from COVID-19.”
Relation to COVID-19
Many wonder whether MIS-C is related to the novel coronavirus. Experts said a positive test result is a marker but the specific relation has yet to be understood.
The first MIS-C cases were reported in the U.K. and Italy. On April 13, the medical journal the Lancet reported "the number of Kawasaki-like diseases increased more than 30 times than usual when comparing the pre- and post-COVID-19 outbreak in Bergamo, Italy.” The number of suspected MIS-C patients also surged in New York, where COVID-19 cases soared around the same period.
Later, the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) announced case studies in May, including cases in which patients were tested positive for RT-PCR or antibody tests for COVID-19.
In Korea, clinical symptoms such as fever and multi-organ inflammation of two or more organs are also suggested as conditions for diagnosis if the antibody test for coronavirus is positive. However, a specific process in which COVID-19 causes MIS-C has yet to be determined.
Some studies have been looking into why most children presenting with MIS-C have had none of the antibodies associated with other coronaviruses that cause mild colds, and which most children have been exposed to.
According to a study published in the scientific journal Cell, a research team raised the possibility that the presence or absence of other coronavirus infection experiences caused a difference in the immune response to the novel coronavirus, which seems to have triggered the MIS-C outbreak. But experts said this is still a hypothesis.
What parents should do if a child shows symptoms
It is necessary to be well aware of the right information and follow various lifestyle rules that can reduce the spread of the highly contagious virus such as maintaining personal hygiene, wearing masks, and avoiding crowded places. Seek emergency care right away if your child shows any of the warning signs of MIS-C or other concerning signs that include difficulty in breathing, pain or pressure in the chest that does not go away, difficulty waking up, losing consciousness, bluish lips or face and severe abdominal pain.