During the pandemic COVID-19 to hospitals in Italy, Germany, UK, Switzerland, France, Spain, Italy and America are increasingly began to receive children with unusual symptoms: abdominal pain, rash on body, high fever, vomiting. Outwardly, it looks like inflammation Kawasaki syndrome, which are detected rarely. But now in some countries for a short time, the number of such cases has increased several times! In new York, the hospital received dozens of children with this syndrome, few have died.
And almost all of them were either infected with coronavirus, or already ill.
Some scientists link the phenomenon with Kawasaki COVID-19, and someone suggests that the manifestations of this syndrome is the result of the cancellation of a planned vaccination in children in connection with the pandemic. What people think on this score by Russian experts? In the background there is this Kawasaki syndrome? And as far as this problem is actual for Russia?
the questions of “MK” responsible head of the Department of diagnosis and restorative treatment, head of the Center for infectious diseases FGAU “SMRC children’s health” of Ministry of health of Russia, MD, Professor Maia BAKRADZE.
“should be Alerted at least five signs”
— This hyperosmolality syndrome in children is extremely rare and against the background of what occurs is still unknown, explained Maya Jamalova. — In fact — it is a systemic vasculitis, mainly affecting medium and small arteries, which leads to the development of aneurysms, blood clots. For the first time, Kawasaki syndrome was established and described in Japan in 1967. The name was given by the Japanese doctor Tomisaku Kawasaki, he has long watched and treated children who have these symptoms manifested.
— And what are the symptoms most characteristic in this syndrome? How to distinguish it from other manifestations of the disease? After all, a body rash, high temperature, typical of many childhood pathologies…
— There are many other more serious signs of this disease, which must be taken into consideration in the diagnosis. Cheerleaders should take a minimum of five symptoms: high fever (up to 40°C); the change on the part of the eye (scleritis); rash; peripheral edema (of hands and feet); bright crimson language; lymphadenitis (swollen lymph nodes, especially the cervical), more often unilateral. The main difficulty of diagnosis of this syndrome is that all 5 signs are seen rarely: often a combination of two or three. But in all cases it is urgent to begin treatment, to the 10th day of the disease is to eliminate inflammation of the coronary arteries, formation of blood clots. And this is a risk factors of myocardial infarction and death.
— And this is in young children? Are there any effective medicines against this mysterious Kawasaki?
�� Yes, up to 90% coming from this syndrome — children under 5 years. The risk of serious consequences most of them can be prevented if the time to start introducing high doses of intravenous immunoglobulin in combination with acetylsalicylic acid. But the problem is that often the symptoms are erased. And to establish a single cause of the disease yet no one in the world has failed. To this day in different countries, studies are carried out to establish the source of the disease in babies. But the scientific justification of the reasons for the emergence of this “strange” syndrome has not yet been found.
Even the American colleagues in their studies of new cases of Kawasaki syndrome during the pandemic COVID-19 divided the patients into two groups: children who have Kawasaki syndrome arose after suffering kovid infection, and children who have the syndrome evolved independently, even without contact with novel coronavirus infection.
All the viruses to blame? So maybe the reason for the growth in children Kawasaki syndrome in Europe became COVID-19? Because this factor were more likely to identify the period of the pandemic and mostly in cases of coronavirus?
— Proven data yet. It viruses, bacteria or other pathogens — international medical community is not known. Unfortunately, no one has proven how this occurs hyperosmolality syndrome.
maybe the reason is that now because of the pandemic, children temporarily stopped doing routine vaccinations, such as varicella. And this was the reason for the growth of Kawasaki syndrome?
— a Temporary suspension of the vaccination can provoke the development of such a syndrome, because this year children immunized in the world is only a month or two, in Russia — one month. It is not enough for the child’s body reacted this way. Must pass at least a year.
“COVID-19 works as a trigger”
— Maya Jamalova, your clinic now treating children with coronavirus? How is their recovery? Among them patients with dangerous Kawasaki syndrome?
— In our clinic, children with this syndrome, fortunately, no. And with the suspicion and confirmed diagnosis COVID-19 to the us for treatment received (21 April) around 400 children. To date written around half of young patients. Today in the clinic, 150 of these children, 20 of them in a more serious condition. But there is treatment, treatment scheme proposed by the Ministry of health, is yielding positive results.
In the guideline, approved in 2016 by the Ministry of health of Russia about the “Mucous-cutaneous lymphonodular Kawasaki syndrome in children”, says: “In Russia, Kawasaki syndrome is diagnosed more frequently, but often in the later stages, resulting in late treatment and not inalways adequately. According to epidemiological studies conducted in the Irkutsk region from 2005 to 2009, the average incidence was 2.7 per 100 thousand children aged 0-17 years and 6.6 per 100 thousand children under 5 years, the authors recognize that these figures may be understated. Approximately 90-95% of those affected were children under the age of 10 years; 85-90% of cases in patients under 5 years of age. Most sick infants 9-11 months. The peak incidence occurs in winter and spring”.
Also, the Ministry of health of Russia does not exclude the viral nature of Kawasaki syndrome. “The factors causing Kawasaki disease, to the present time is not set, it’s assumed that a combination of genetic predisposition and exposure to certain viruses”, — stated in the guideline of the Ministry.
by the Way, in our country since the 2003 Kawasaki syndrome began to study at the Department of children’s diseases sechenovskiy University. Through the hands of scientists were more than 300 patients with this diagnosis. And the preliminary conclusion is: “it is possible that the coronavirus may be the same trigger for Kawasaki, like Streptococcus, Staphylococcus and other viruses,” said Professor of the Department of childhood diseases of the University Natalia Golovanova. It does not exclude that in the period of the pandemic COVID-19 “the risk of disease is higher”.
…And while scientists doubt, in Western countries on the background of the pandemic COVID-19 continue increasingly to identify this hyperosmolality dangerous to children Kawasaki syndrome. Recorded more than a hundred such cases. In the same time many of these children are identified and coronavirus. Experts, including the Russian, coming to the conclusion that the relationship between these two diseases still exists.
And the world health organization (who) urges the physicians of all countries “to pay special attention to the reports that some children infected with coronavirus, symptoms, similarities with another disease — Kawasaki syndrome (Multisystem inflammatory syndrome)”. According to who experts, “according to preliminary data, the development of Kawasaki syndrome may be associated with infection with coronavirus. Infection itself COVID-19 is not the cause of the disease, but it works like a trigger, causing changes in the immune system.”
…And possibly a new coronavirus, thus began to mutate?
