https://www.dailymail.co.uk/news/article-8327027/Baby-dies-coronavirus-linked-Kawasaki-disease-aged-eight-months.htmlBaby dies of coronavirus-linked Kawasaki disease aged eight months becoming Britain's youngest known victim of rare childhood syndrome
Alexander Parsons was admitted to Plymouth's Derriford Hospital on April 6
He had no underlying health conditions and was diagnosed with the disease
The illness causes blood vessels to swell in the body and is linked to coronavirus
Baby boy's mother, Kathryn Rowlands, 29, said: 'I will never be whole again'
Here’s how to help people impacted by Covid-19
By Katie Weston For Mailonline
Published: 22:47, 16 May 2020 | Updated: 07:54, 17 May 2020
A baby has died of the coronavirus-linked Kawasaki disease aged eight months, becoming Britain's youngest known victim of the rare childhood syndrome. Alexander Parsons, who had no underlying health conditions, passed away aged eight months after being admitted to Plymouth's Derriford Hospital on April 6 and suffering a ruptured aneurysm. He was diagnosed with Kawasaki disease, which causes blood vessels throughout the body to swell, after developing a 'pinprick' rash, fever, and swollen lymph nodes. The baby boy died in the arms of his mother, Kathryn Rowlands, 29, who said she will 'never be whole again'.
She told the Mirror: 'I can't believe I carried him for longer than he was alive. I will never be whole again. 'He was my greatest achievement. He could have gone on to do whatever he wanted with his life. Now he'll only ever be eight months old.'
Praising the medical staff who tried to save Alex, she added: 'The doctors and nurses who fought to save Alex were incredible but if they'd known more about the COVID-Kawasaki link, they possibly could have done more.'
The illness, which the Centers for Disease Control and Prevention (CDC) called multisystem inflammatory syndrome in children (MIS-C), was found by scientists to be caused by coronavirus last month. The CDC previously said: 'Healthcare providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local, state, or territorial health department.'
The condition had previously been referred to as Pediatric Multisystem Inflammatory Syndrome (PMIS) by the state of New York in the United States where there have been more than a hundred reported cases, including at least three deaths. Treatment involves injecting antibodies as well as administering steroids and aspirin in case patients experienced a sudden loss of blood pressure, called 'shock.' In other developments to the coronavirus crisis today:
* Britain announces 468 more coronavirus deaths on the first Saturday since lockdown was eased taking the country's total fatalities to 34,466;
* Scuffles between police and anti-lockdown protestors have broken out in Hyde Park and across the UK;
* The row between ministers and teachers unions intensified after Children's Commissioner for England Anne Longfield said that schools had to be reopened as quickly as possible;
* Public Health England could face the ax after Boris Johnson told a meeting of 1922 Committee of backbench Tory MPs that he was planning a review of 'a number of institutions' once coronavirus is beaten back;
* Experts from King's College London have suggested that one in three patients who fall severely ill with coronavirus develop deadly blood clots that trigger heart attacks, strokes and organ failure;
* NHS Chief Executive Simon Stevens said that medics are still treating around 9,000 coronavirus patients a day in England, down from 19,000 at the infection's peak in April;
* The University of Nottingham has suggested that coronavirus cases fell dramatically after the sunniest April on record, with strong UV light killing the virus and vitamin D strengthening the immune system.
Sunil Sood, a pediatrician at Cohen Children's Medical Center in New York, said that cases mainly seemed to emerge four to six weeks after a child had been infected and had already developed antibodies. 'They had the virus, the body fought it off earlier. But now there's this delayed exaggerated immune response,' he said.
Doctors should be on the lookout for the condition and report suspected cases to local or state health departments. It should be suspected in all deaths in children who had evidence of Covid-19 infection, the CDC said.
Gavin Williamson promises it WILL be safe for children to go back to school on June 1 as pupils and their families will get free coronavirus track-and trace tests and be put into protective 'class bubbles'
By David Wilcock, Whitehall Correspondent for MailOnline
Schools will throw a 'protective bubble' around young pupils, Gavin Williamson vowed today as he attempted to outflank furious teaching unions and reopen classrooms next month. The Education Secretary attempted to pile pressure on opponents of his plans tonight as he warned of the dire 'consequences if children did not start returning to school. He made a blunt appeal to the emotions of parents tonight as he insisted planning can begin to reopen classrooms from in little more than a fortnight. Outlining his plans for reception, year 1 and 6 as well as years 10 and 12 to return from June 1, he insisted 'they stand to lose more by staying away from school'.
He revealed that those who return, as well as their parents, will join teachers in being eligible for free coronavirus tests, as he outlined measures schools will take to avoid a surge in the killer disease. They include small classes and keeping children in small socially-distanced groups, with Mr. Williamson saying: 'We are creating a protective bubble around them, reducing the amount of mixing and making sure that these small groups stay together, almost like a family within a classroom.'
Asked about testing and tracing, Mr. Williamson added: 'School staff can already be tested for the virus, but from the first of June we'll extend that to cover children and their families if any of them develop symptoms. Together these measures will create an inherently safer system where the risk of transmission is substantially reduced for children, their teachers, and also their families.'
However, concerns have been raised over the track and trace regime amid fears there is not enough staff to run it alongside a smartphone app. It was the latest development in a boiling row between ministers, trade unions and local authorities over the safety of sending children back to school. Hartlepool in County Durham joined Liverpool this morning in saying it would ignore the Government's plan to let some primary school pupils back to the school from June 1. And the doctor's union added its weight to the opposition, saying teachers representatives are 'absolutely right' to argue it is unsafe for schools to open next month. But at a press conference, Mr. Williamson said: 'There is a consequence to this, the longer that schools are closed the more that children miss out. Teachers know that there are children out there that have not spoken or played with another child their own age for the last two months. They know there are children from difficult or very unhappy homes for whom the school is the happiest moment in their week, and it's also the safest place for them to be.'
Young children will still be able to socially distance at school, the deputy chief medical officer has said. Speaking at Saturday's Downing Street briefing, deputy chief medical officer Dr. Jenny Harries explained how social distancing can work in classrooms with young children. Dr. Harris said plans include having small groups 'where you increase the level of interaction a small amount, but it is contained'.
She said: 'Although it is recognised that small children will run around and interact, we expect them to, but you can still distance. I know this is the plan.'
She also suggested that desks could be placed appropriate distances apart from one another to prevent long periods of close contact. Dr. Harries added: 'A child rushing past another one in a normal area is probably not much of a risk. But if they were sitting directly opposite to each other in a very small space, close together for a long amount of time that might be more of a risk. All of the interventions are designed to minimise those, while still allowing children to learn.'
Scientists in the UK find first clear evidence that coronavirus infection is linked to Kawasaki-like inflammatory condition
By Joe Pinkstone for MailOnline, 14 May 2020
Scientists have found the first clear evidence that infection with coronavirus causes the Kawasaki-like inflammatory condition affecting children. A study of eight children admitted to a Birmingham hospital with the condition reveals they were infected with the SARS-CoV-2 virus several weeks before showing symptoms. All of the children tested negative in the traditional lab-based test used to diagnose COVID-19 in adults. However, a custom-built antibody test revealed that young patients had been infected with the coronavirus and produced antibodies to fight off the pathogen. Doctors who treated the children say antibody tests are the only way to accurately identify the presence of the virus in children suffering from the hyperinflammatory condition, which can be fatal. It remains unknown why the syndrome develops weeks after infection, but scientists believe it may be due to a severe overreaction from the body's own immune system. This 'immune-mediated pathology' causes the immune system to go haywire and can cause damage to the body's own cells. A similar phenomenon has been seen in adults, and it can be fatal to the sickest patients. The syndrome affecting children has been tentatively called PIMS-TS, for 'paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2'.
However, the British scientists say the condition's definition is incorrect as it is not 'temporally associated' with the pandemic but is instead 'triggered by SARS-CoV-2 infection'.
A team of scientists led by Dr. Alex Richter and Professor Adam Cunningham of the University of Birmingham studied eight young patients who were admitted to hospital between April 28 and May 8. Lab tests that are used to identify COVID-19 and also to screen healthcare workers came back negative for all eight individuals. These tests, called PCR tests, are extremely reliable and are 'the nearest to a gold standard for determining active infection'.
Professor Adam Cunningham, who led on the research alongside Dr. Alex Richter and Dr. Barney Scholefield, told MailOnline: 'The PCR picks up the presence of the virus itself, so the virus needs to be present at the site in the throat where the sample (usually a throat swab is taken). 'If you clear the infection then there will not be a virus there to detect. In response to infections, we often make antibodies, and these are usually detectable from 14 days after the first time you are infected. These antibody responses often persist in the body for months and often many years afterward.'
The average age of the children admitted to the hospital was nine years old and five of the patients were boys. Seven of the patients showed symptoms of both hyper inflammation and Kawasaki disease. One of the patients was expressing symptoms of hyper inflammation as well as some signs of toxic shock syndrome. The mysterious and dangerous condition is being described by top medical professionals as very rare and symptoms can include fever, abdominal pain, rashes, and red lips, and eyes. A very small group goes into shock, in which the heart is affected, and they may get cold hands and feet and have rapid breathing. Of the eight children treated in Birmingham and studied as part of this landmark research, all patients had a fever and at least one gastrointestinal symptom such as abdominal pain, vomiting, and diarrhoea. Six of the patients required admission into paediatric intensive care due to heart-related issues and low blood pressure brought on by the disease. All showed positive signs after treatment and have since been discharged from ICU. Due to the reports in the media and claims from leading advisers and prominent politicians that this condition may be linked to the coronavirus pandemic, the researchers took blood samples for analysis from all eight children. They then developed a custom antibody test with the help of researchers at the University of Southampton. The test involves making an artificial copy of a key protein on the surface of the coronavirus which looks like a spike. This unique 'spike' is a key identifier of the killer virus and was first revealed in detail by Professor Max Crispin of the University of Southampton. He modeled the protein's surface spikes and this has allowed his team to produce an almost exact copy of the spike. In the Birmingham hospital, this artificially created version of the protein spike was mixed with blood samples from the patients. The researchers saw that some antibodies in the blood of the children bound to the spike, in the same way, they would if the virus itself was invading. In the tests, researchers looked to see which of three different immunoglobulins (the technical name for an antibody) IgG, IgA, and IgM locked onto the imitation virus. A positive IgM reading in the tests indicates a recent infection whereas a positive reading for IgG and IgA shows an older infection, the scientists say. The children in the Birmingham hospital had no IgM antibodies but did have IgG and IgA antibodies, showing that they were infected with SARS-CoV-2 several weeks previously. This time delay is the reason the PCR test did not detect the infection, the researchers say. 'IgM was not detected in children, which contrasts with adult hospitalised adult COVID-19 patients of whom all had positive IgM responses,' the researchers write in the study, which has been submitted to a preprint server and seen by MailOnline. 'For antibody responses, IgM responses develop first, before eventually waning and IgG responses dominating thereafter,' the researchers explain. Thus, high levels of IgG in the absence of IgM are typically suggestive of infection weeks or even months previously.'
This antibody test is conducted in a laboratory and is not a portable test. It is also fundamentally different to the test approved by the government today, which is manufactured by Roche. Roche's method uses a nucleoprotein to mimic the SARS-CoV-2 virus, not the viral spike. 'Using the native-like viral spike for antibody testing is proving a highly sensitive way of detecting exposure to SARS-CoV-2,' Professor Crispin told MailOnline.
The researchers say their research shows that the only way to diagnose patients with symptoms of severe inflammatory syndrome who have tested negative for the PCR is via antibody testing. Dr. Cunningham says: 'In our study, none of the children were positive by PCR, yet all of the children were positive by antibody testing. This may mean that the disease developed after the kids have already cleared the virus. If so, then serology may be more useful diagnostically for kids who are PCR negative. What the antibody test tells us is that these children have definitely been infected with SARS-CoV-2 at some time in the past, which will hopefully help doctors make decisions on how to treat these patients. Ultimately, both PCR and antibody testing have overlapping roles to play in diagnosing this syndrome. Really excitingly, the detection of the antibodies may also provide clues on how this syndrome develops.'
As a result of their findings, the researchers suggest changing the definition of PIMS-TS, as the Kawasaki-like condition is now known. 'Since all patients were positive serologically, it may be worth considering amending the definition of PIMS-TS so that TS is not just 'temporally associated with SARS-CoV-2 pandemic', but 'triggered by SARS-CoV-2 infection',' the researchers conclude in their study.
What is Kawasaki disease and how is it usually treated?
Kawasaki disease is a condition that mainly affects children under the age of five. The cause of it is unknown, but it is believed to be an autoimmune response to an infection. Around eight in every 100,000 children develop Kawasaki disease in the UK each year. Its characteristic symptoms include a rash, swollen glands, dry or cracked lips, red fingers or toes, and red eyes. According to the NHS it is always treated in hospital and anyone who notices symptoms in a child is told to speak to their GP or call 111 urgently. Intravenous immunoglobulin (IVIG), a solution of antibodies, and aspirin are the two main medicines used. Though children can make a full recovery within six to eight weeks, some complications can develop from the condition, including with the heart. If untreated, complications can be fatal in about 2 to 3 percent of cases.
Source: NHS England
