The federal government has called on Australia’s top Kawasaki disease experts to investigate a mystery illness linked to coronavirus that has killed three children in New York.
The auto-immune disease called PIMS-TS is closely related to the rare Kawasaki disease, which is usually found in children, with cases reported in areas with a high outbreak of COVID-19
In the United States there have been 73 reported cases of the condition, while it has also been recorded in children in the United Kingdom and in Italy.
During his Wednesday press briefing, Australian Deputy Chief Medical Officer Paul Kelly said “there’s been no known increase in Kawasaki in Australia, and no cases of this PIMS-TS”.
Deputy Chief Medical Officer Professor Paul Kelly. Source: AAP
While Kawasaki disease is very rare, and often recoverable, Australian health professionals are on high alert and working to see if there is in fact a link between PIMS-TS and coronavirus.
What is Kawasaki disease and PIMS-TS?
Kawasaki disease is a rare inflammatory condition found in children that causes the walls of blood vessels in the body to become inflamed.
The disease was first reported in Japanese paediatricians in 1967 and is usually caused by an overreaction in a child’s immune system to one or more infections.
Professor David Burgner, a paediatric and infectious diseases doctor with the Murdoch Children’s Research Institute in Melbourne, says there is usually around 300 cases of Kawasaki disease in Australia every year.
“As paediatricians we see a fair bit of Kawasaki disease, but we still don’t know what causes it,” he said.
“Usually with early treatment most children make a complete recovery.”
Symptoms of Kawasaki disease include a rash, bloodshot eyes, high fever, joint pain as well as swollen hands and feet.
Prof Burgner said while there was “some overlap between Kawasaki disease and PIMS-TS,” there were also several key differences.
“Patients with this new syndrome have gone into shock, their blood pressure drops, and their heart muscle can’t contract very well,” he said.
Prof David Burgner, a paediatric and infectious diseases doctor, says there is no definitive link between COVID-19 and Kawasaki disease. Source: Murdoch Children's Research Institute
“One of the most striking features is patients often present with severe abdominal pain and signs of Toxic Shock Syndrome.
“There is certainly a lot of similarities in symptoms with Kawasaki disease but the kids with PIMS-TS seem much sicker.”
Is there a link between Kawasaki disease and PIMS-TS with coronavirus?
Prof Burgner said there has been no clear data to suggest COVID-19 has caused increased cases of Kawasaki disease.
While links between PIMS-TS and coronavirus are also unsubstantiated, Prof Burgner says it can’t be completely ruled out.
“It seems likely that there are many different infections that could act as a trigger for Kawasaki disease, whereas this PIMS-TS looks like it follows infection with COVID-19 so it seems relatively specific.
“However, that is very speculative as at the moment the numbers of cases are very small so it is difficult to come to any conclusions.
“This is a rare complication of an infection that is relatively rare in children. Even where there is a lot of community transmission like in places like the US and the UK, we fortunately haven’t had that in Australia so I expect cases to be few and far between.”
Are Australian children at risk?
Parents should not be concerned about Kawasaki disease or PIMS-TS, according to Australian Chief Medical officer Brendan Murphy.
Professor Murphy said with Australia’s so-far-successful efforts to stop the spread of coronavirus, he would be surprised to see multiple cases of PIMS-TS here.
“It may appear in other countries with large volumes of infected people but because it is so rare it is unlikely to appear in Australia,” he said.
“We’ve got alerts on it and we’re clearly watching it.”
Prof Burgner said parents should not “be influenced” by reports from other countries.
“The government has not received any new advice about Kawasaki disease or PIMS-TS and I think that is entirely appropriate.
“Parents should be aware of this but they shouldn’t be anxious or concerned.
“The chances in Australia of a child getting sick from PIMS-TS is very tiny, although not impossible. We must keep these things in perspective.”
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