In May, two parents rushed their 8-year-old daughter Xitlali Vasquez to Children’s Hospital in Los Angeles because of a spiked temperature and delirium that sent their daughter into a fevered sleep that lasted several days. The 8-year-old was then placed in intensive care for specialists to tend to the inflammation around her heart and arteries.
Rosa Vasquez, Xitlali’s mother, said, “It was just like a nightmare.” She added, “There was a time where I thought she was going to die.”
Xitlali was one of the first children in Los Angeles County to be diagnosed with the multisystem inflammatory syndrome, a rare and potentially deadly illness known as MIS-C that infects children exposed to the coronavirus.
Seven months after her diagnosis, at least 45 more children in the county have been diagnosed with MIS-C, and one has died.
Similar to the coronavirus that has infected the majority of Black and Latino communities, MIS-C has also disproportionately infected Black and Latino children.
According to data from the public health department, in Los Angeles County, Latino children like Xitlali account for 73% of recorded cases, and Latino kids make up 40% of the world’s MIS-C cases. According to most recent statistics from the Centers for Disease Control and Prevention, black children make up the second-largest group, with 36% of all cases.
The Mayo Clinic indicates that disparities in healthcare access and the likelihood of genetic hazards may play a role in the discrepancy, but says that more studies are required to help determine why Black and Latino children are affected by MIS-C more frequently than others.
In Xitlali’s case, the girl may have contracted the virus from her parents. Rosa and her husband were both sick with what seemed to be COVID-19 symptoms in late March. The pair, however, tested negative for the virus. None of their 12- and 24-year-old sons fell ill, nor did Vasquez’s 68-year-old mother.
Xitlali, who is often by her mother’s side, didn’t show signs of the coronavirus until weeks later when her eyes turned bloodshot, and a fever pushed the girl to the point of delirium.
Much remains unclear regarding MIS-C, including its long-term consequences, whether any children are genetically predisposed to the disease and whether the number of cases could be greater. Researchers suspect that some kids diagnosed with Kawasaki disease between January and May, a rare inflammatory disease that affects about 5,500 kids per year in the U.S., may have had MIS-C instead.
What is evident is that cases of MIS-C are closely related to a rise in COVID-19 infections, a connection that doctors say could easily balance a possible uptick during the holidays, considering the continuing spike in cases of coronavirus. According to the California Department of Public Health, seven new children have been diagnosed with the condition across the state in the past week.
Dr. Jackie Szmuszkovicz, Xitlali’s pediatric cardiologist at Children’s Hospital Los Angeles, said, “With the number of coronavirus cases we’re seeing in Los Angeles now, I do expect to see more children with MIS-C coming into the hospital in the next few weeks.” She said, “We’re at a critical moment right now.”
According to a Times review of data from the CDC, the enigmatic syndrome has killed at least 23 children in the U.S. and infected more than 1,280, counts that have risen by more than 125 percent since July. The data was last registered on Dec. 4 and will be updated in January.
Patients under one year of age and up to 20 years of age have been diagnosed with MIS-C; the majority are 7 to 9.
According to the state Department of Public Health, at least 152 children have fallen ill with MIS-C in California.
This month, one child died from the virus. Health officials at Children’s Hospital Los Angeles, where the patient was being treated, said the child had a “complex, pre-existing cardiac condition” and died of MIS-C-related complications. The death marks the county’s first child fatality related to COVID-19.
The state’s health department does not separate MIS-C deaths from COVID-19 fatalities. Out of the 22,000 COVID-19 related deaths in California, three were children 17 or younger.
Although the condition is unusual, it can be extreme and potentially fatal. Children usually experience signs of MIS-C approximately four to five weeks after exposure to coronavirus, which often goes undetected since asymptomatic carriers are the majority of children. Fever, abdominal and neck pain, vomiting, diarrhea, rash, swollen lips, bloodshot eyes, and fatigue are signs of MIS-C.
Doctors say that children have arrived at the hospital with a fever only to be discharged and to return days later in shock. Others have been admitted with labored breathing and have to be given oxygen or placed on a ventilator. A diagnosis of MIS-C is generally made only after a child tests positive for antibodies to COVID-19.
“There are kids that are not sick enough to be admitted. Then there are children that go directly into shock with multi-organ failure,” said Dr. Jane Burns, a professor and director of the Kawasaki Disease Research Center at UC San Diego. “We don’t understand why the heart muscles basically pump poorly in these children, but that can be reversed very quickly with the right cocktail of inflammatory treatment. They can go from death’s doorstep in one day.”
A CDC study from August said that obesity among children with MIS-C was the most frequently identified underlying medical condition. However, the study found that two-thirds of the children diagnosed at that time did not have preexisting conditions.
At her checkup in January, Vasquez said Xitlali had been given a clean health bill. After her bout with MIS-C, she developed type 1 diabetes, which Vasquez thinks is partially due to inflammation in her pancreas linked to MIS-C.
Health experts agree that the secret to mitigating the seriousness of MIS-C is early care. A combination of scant disease awareness, hospital and doctor’s office avoidance in the midst of the pandemic, and the fact that initial symptoms sometimes appear in the GI tract, close to the flu, has left some kids in the emergency room after mild symptoms become extreme.
“Please do not delay in seeking care for your child if they are ill,” Szmuszkovicz said. “Length of stay is going to be shorter if we can get the inflammation under control earlier.”
Vasquez, who still shudders at the memory of that May day as doctors worked frantically to restart Xitlali’s heart, knows all too well how quickly things can take a turn for the worse.
“Our kids get sick, and we want to treat them with home remedies and Tylenol without knowing that they could die without taking them to the right place,” she said.
Recently, Xitlali turned to her mother as a news report blared on the television.
“There was a little kid that died because of the same thing that I had,” she told her mother in disbelief.
Fear persists for the young girl. But she is alive. And for that, her mother is grateful.