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Paediatric consultant says reports of inflammatory symptoms in some children need to be kept in perspective

The symptoms include gastrointestinal issues and abdominal pain.
Apr 28th 2020, 10:47 AM 48,573 19

Updated Apr 28th 2020, 1:55 PM

A PAEDIATRIC CONSULTANT has said it’s important to keep reports of inflammatory symptoms in some children in the UK in perspective and reminded parents to refer their children to doctors if they are showing any signs of illness. 

Paediatricians in Ireland have been told to be “on the lookout” for symptoms that have shown up in some children in London and other parts of the UK who have Covid-19, including high fever, red eyes and gastrointestinal issues. 

Dr Patrick Gavin, a consultant in paediatric infectious diseases, told RTÉ radio’s News At One that Covid-19 remains to be a relatively mild illness in most children from what health professionals know at the moment. 

“We see far more kids presenting with a shock-like state from bacterial infection complicating chicken pox every year than we are going to see with potential association with Covid,” he said.

“I think its important to keep it in perspective – this was a notice to alert general practitioners to refer children with unusual symptoms and we need to bear that in mind for the public.

Doctors were recently issued an alert by NHS England about a number of children who presented with a multi-system inflammatory state requiring intensive care across London and other parts of the UK.  

“This information is preliminary based on an alert to primary care practitioners in the UK so we don’t have a full set of information,” Gavin said. 

Dr Gavin added that it’s difficult to know at this time whether this is an epiphenomenon, happening at the same time as Covid-19. 

“We have seen late presentation of certain emergencies in terms of diabetic ketocidosis and appendicitis in the setting of Covid because people are reluctant to see their GP or attend the emergency room,” he said, advising that parents should not delay seeking any medical attention for their children.   

Gavin said around 20 children in Ireland with Covid-19 have been admitted to hospital, two have entered into an Intensive Care Unit and there have been no paediatric deaths from the disease. 

Speaking to RTÉ radio’s Morning Ireland, Professor Karina Butler said all paediatricians have been alerted to look out for the unusual symptoms. 

Butler is a professor of clinical paediatrics at University College Dublin and a member of the Coronavirus Expert Advisory Group.

“We became aware over the weekend of an alert that was issued from the UK and from London where they are noticing presentations of a very inflammatory state in rare children where they have high fever, red eyes and predominant gastrointestinal symptoms, abdominal pain,” Butler said. 

“That is very like another syndrome we are familiar with in pediatrics called Kawasaki syndrome or like what we call a  toxic shock syndrome.

“We have alerted all paediatricians to be on the lookout for that because some of those have developed in children who happened to have Covid. Whether Covid is the cause or not, we don’t know yet but the syndrome has been recognised in children who have that virus.”

She said that “by and large” doctors have seen few cases of the virus in children.

“The vast majority of cases we have seen have been very mild almost to the point of being incidental pickups,” she said. 

“We do know that that is not always the case and there are children who can become critically ill with this virus.” 

Butler said the country at the moment is in a “better place” than it would be if restrictive measures and other steps taken to slow down the spread of the virus were not made in the beginning. 

She added that any return to normality would be at a “crawl” to prevent any large increases in case numbers. 

“We have to be sure that we have everything in place so that if there are any flare ups or hot spots, they can be rapidly identified and that wherever it’s happening it can be ring fenced so it doesn’t spread into the wider community.”  

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