Multisystem Inflammatory Syndrome in Children (MIS-C)

Multisystem inflammatory syndrome in children (MIS-C), COVID-19 associated, is an emerging condition that is characterized by inflammation of multiple areas of the body, including the heart, lungs, skin, eyes, brain, kidneys, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including bloodshot eyes, rash, abdominal (gut) pain, diarrhea, vomiting, neck pain, or feeling extremely tired. The cause of MIS-C has not been determined. However, many children with MIS-C had the virus that causes COVID-19 or had been around someone with COVID-19.

Alabama Statistics

Although not explicitly reportable in Alabama, 22 cases of MIS-C have been reported. No MIS-C related deaths have been reported in Alabama.

United States Statistics

There have been 1,659 cases of MIS-C, including 26 deaths, reported in the United States. For the latest information on cases reported by the CDC, visit Health Department-Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in the United States.

Information for Providers

Reporting Criteria

As described in the CDC Health Advisory, “Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19),” using the following criteria is recommended for the identification of potential cases of MIS-C:

  • An individual aged <21 years presenting with fever*, laboratory evidence of inflammation**, and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND
  • No alternative plausible diagnoses; AND
  • Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or exposure to a suspected or confirmed COVID-19 case within the 4 weeks prior to the onset of symptoms.

*Fever >38.0°C for ≥24 hours, or report of subjective fever lasting ≥24 hours
**Including, but not limited to, one or more of the following: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin
Individuals diagnosed with Kawasaki disease, or those that meet partial criteria for Kawasaki disease, should not excluded if they meet the reporting criteria for MIS-C.

Additional comments:

  • Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection.

How To Report

COVID-19 associated MIS-C cases may be reported to the Alabama Department of Public Health (ADPH) via the Communicable Disease REPORT Card system. Upon opening the REPORT card, there will be a drop-down menu with multiple diseases listed. Select the "Multisystem Inflammatory Syndrome in Children (MIS-C), COVID-19 associated" option and fill in the requested information and upload the following document files to the REPORT card:

  • History and Physical
  • Discharge Summary
  • Laboratory Reports
  • Imaging Reports [e.g., Chest Computed Tomography (CT), Chest Radiograph X-ray, etc.]

If the documents are not uploaded with the submission, ADPH staff will contact the reporter to request any additional information.

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Page last updated: January 22, 2021