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Four children in Singapore have developed paediatric multi-system inflammatory syndrome in children (MIS-C), which is a syndrome linked to a previous Covid-19 infection.

The Ministry of Health (MOH) provided this update late on Saturday, Nov. 6.

Among the four cases, a four-year-old boy is still in the Children’s Intensive Care Unit (CICU).

Out of the remaining three, one is in a general ward, and two have been discharged.

The four cases are:

a. A three-year-old boy admitted to the National University Hospital (NUH) CICU on Oct. 16, 2021. He had repeatedly tested PCR-negative, but his serology test results indicated that he likely had a Covid-19 infection two to six weeks prior to the development of MIS-C. He has since recovered and was discharged on Oct. 23.

b. An eight-year-old boy admitted to KK Women’s and Children’s Hospital’s (KKH) CICU on Oct. 27, 2021. He had been previously diagnosed with Covid-19 infection on Sep. 30. He has since recovered and was

discharged on Nov. 1.

c. A four-year-old boy admitted to KKH CICU on Nov. 1, 2021. As of Nov. 7, the boy remains in the CICU and his breathing is supported by mechanical ventilation. He had previously tested positive for Covid-19 infection on Sep. 24. The KKH paediatric teams are actively managing his care.

d. A two-month-old female infant admitted to KKH General Ward on Nov. 3, 2021. She was previously admitted to KKH for Covid-19 infection on Oct. 12, and discharged on Oct. 19. The patient’s condition remains stable, with no oxygen requirements.

What is inflammatory syndrome?

MIS-C is considered rare and the four cases have been detected among the more than 8,000 children infected with the coronavirus here since the start of the pandemic, MOH said.

MIS-C is similar to Kawasaki Disease (KD), which has been linked to various virus or bacterial infections, and occurs in 150 to 200 children a year in Singapore.

Symptoms of MIS-C include persistent fever above 38.5°C for three days or more, with difficulty breathing, headache, neck swelling, rash, swollen hands and feet, conjunctivitis, diarrhoea, or abdominal pain.

Kawasaki Disease results in inflammation in blood vessels throughout the body, and generally affects those younger than five years old.

MOH added that an international review from 26 countries in May 2020 reported the MIS-C incidence rate of 0.14 per cent (14 in 10,000) among all children with Covid-19 infection.

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