{"id":10403,"date":"2025-03-01T14:07:56","date_gmt":"2025-03-01T19:07:56","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan430\/"},"modified":"2025-03-02T00:55:05","modified_gmt":"2025-03-02T05:55:05","slug":"dhan430","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan430\/","title":{"rendered":"php\/alerts\/dhan430 ~  Division of Public Health  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan430.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->430 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->May 18, 2020 9:53 am <!--[END]--> <\/h2>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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Please note \n\n\n\n\n\nthat while older adults are at risk for severe COVID-19 illness, children can still get sick with COVID-19, most \n\n\n\n\n\noften presenting with mild symptoms, but rarely becoming severely ill. COVID-19 cases, and associated clusters, \n\n\n\n\n\nare considered conditions required as reportable to DPH.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>SUMMARY<\/h2>\n\n\n\n\n\n<p>Recently, coronavirus disease 2019 (COVID-19) has been reported as possibly linked with a pediatric multisystem \n\n\n\n\n\ninflammatory syndrome disease \u2013 Multisystem Inflammatory Syndrome in Children (MIS-C). As of May 12, 2020, 102 suspected \n\n\n\n\n\npediatric clinical cases compatible with multisystem inflammatory syndrome associated with COVID-19 have been reported in \n\n\n\n\n\nchildren in New York State hospitals, including New York City. Additionally, Delaware has reportedly identified three cases.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>If there is a strong clinical suspicion of MIS-C, potentially associated with COVID-19, call 1-888-295-5156 to consult \n\n\n\n\n\nwith the DPH Office of Infectious Disease Epidemiology, or report through <a href=\"mailto:reportdisease@delaware.gov\">reportdisease@delaware.gov<\/a>, within 24 hours of \n\n\n\n\n\nclinical suspicion or submission of test samples to a commercial lab, to allow for surveillance and monitoring as appropriate. \n\n\n\n\n\nReporting will enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>BACKGROUND<\/h2>\n\n\n\n\n\n<p>In the United Kingdom and Europe, a possible link was reported between COVID-19 and a serious inflammatory disease recently \n\n\n\n\n\ntermed &#8220;Pediatric Multi-System Inflammatory Syndrome Temporally Associated with COVID-19.&#8221; As of May 12, 2020, the New York State \n\n\n\n\n\nDepartment of Health identified 102 patients (including patients from New York City) suspected pediatric clinical cases compatible \n\n\n\n\n\nwith multisystem inflammatory syndrome were reported in children in New York State hospitals, including New York City. Additionally, \n\n\n\n\n\nDelaware has reportedly identified three cases.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>This syndrome has features which overlap with Kawasaki Disease and Toxic Shock Syndrome. Inflammatory markers may be elevated, \n\n\n\n\n\nand fever and abdominal symptoms may be prominent. Rash also may be present. Myocarditis and other cardiovascular changes may be seen.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Additionally, some patients have developed cardiogenic or vasogenic shock and required intensive care.  This inflammatory syndrome, \n\n\n\n\n\nreferred to as MIS-C by CDC, may occur days to weeks after acute COVID-19 illness.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>CASE DEFINITION FOR MULTI-SYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C)<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>An individual aged <21 years presenting with fever<sup>1<\/sup>, laboratory evidence of inflammation<sup>2<\/sup>, and evidence of \n\n\n\n\n\nclinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, \n\n\n\n\n\nrespiratory, hematologic, gastrointestinal, dermatologic or neurological); AND<\/li>\n\n\n\n\n\n\n\n\n\n\n\n<li>No alternative plausible diagnoses; AND<\/li>\n\n\n\n\n\n\n\n\n\n\n\n<li>Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure \n\n\n\n\n\nwithin the four (4) weeks prior to the onset of symptoms.<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p><sup>1<\/sup> Fever >38.0\u00b0C for \u226524 hours, or report of subjective fever lasting \u226524 hours<\/p>\n\n\n\n\n\n<p><sup>2<\/sup> Including, but not limited to, one or more of the following: an elevated C-reactive protein (CRP), \n\n\n\n\n\nerythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), \n\n\n\n\n\nor interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Additional Comments<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C<\/li>\n\n\n\n\n\n<li>Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p><strong>Clinicians should not delay seeking expert advice while waiting for results of these investigations.<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>RECOMMENDATIONS<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Early recognition by pediatricians and prompt referral to an in-patient specialist, including to critical care is essential.<\/li>\n\n\n\n\n\n<li>This syndrome should be considered by pediatricians and specialists, particularly when other microbial etiologies have not been identified.<\/li>\n\n\n\n\n\n<li>Pediatricians and specialists should elicit any recent history of illness with COVID-19 or close contact with individuals who are known to have COVID-19 in children presenting with symptoms that are compatible with pediatric multi-system inflammatory syndrome potentially associated with COVID-19.<\/li>\n\n\n\n\n\n<li>The majority of patients who have presented with this syndrome have tested positive for SARS- COV-2 or corresponding antibodies.  Some tested positive on diagnostic, molecular testing for SARS-COV-2, others were positive on serological testing for corresponding antibodies.<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h2>REPORTING<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>COVID-19 is a reportable condition to DPH under Delaware Code (3.0 Report of Outbreaks and Potential Causes of a Public Health Emergency, 3.1 Outbreaks, Any health care provider, having knowledge of any outbreak of any notifiable disease or clusters of any illness which may be of public concern, shall report such outbreaks within 24 hours to the Division Director or designee.)<\/li>\n\n\n\n\n\n<li>Any positive test results from any laboratory must be reported to DPH via the Delaware Electronic Reporting Surveillance System (DERSS).<\/li>\n\n\n\n\n\n<li>If you have a strong clinical suspicion that a patient may be infected with MIS-C based on clinical symptoms and epidemiological factors (e.g., close contact with a confirmed case, recent travel to an area with sustained transmission), contact the DPH Office of Infectious Disease Epidemiology at 1-888-295-5156, or report through <a href=\"mailto:reportdisease@delaware.gov\">reportdisease@delaware.gov<\/a> within 24 hours of clinical suspicion or submission of test samples to a commercial lab to allow for surveillance and monitoring as appropriate.<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h2 class=\"text-center\">Report to DPH Office of Infectious Disease Epidemiology<br>\n\n\n\n\n\n1-888-295-5156 <a href=\":mailto:reportdisease@delaware.gov\"\">reportdisease@delaware.gov<\/a><\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<h2>RESOURCES<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html\">Centers for Disease Control and Prevention (CDC) COVID-19 Website<\/a><\/li>\n\n\n\n\n\n<li><a href=\"https:\/\/emergency.cdc.gov\/han\/2020\/han00432.asp\">CDC HAN: Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19)<\/a><\/li>\n\n\n\n\n\n<li><a href=\"https:\/\/www.rcpch.ac.uk\/sites\/default\/files\/2020-05\/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf\">Royal College of Paediatrics and Child Health Guidance: Paediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19<\/a><\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/p><a href=\"\"><br>\n\n\n\n\n\n<br>\n\n\n\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n<!--[END]-->\n\n\n  \n\n\n        <div class=\"panel panel-danger\">\n\n\n          <div class=\"panel-heading\">    \n\n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n\n       <\/div>\n\n\n       <div class=\"panel-body\">\n\n\n      <ul>\n\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n\n            <\/ul>\n\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n\n          <\/div> \n\n\n        <\/div><br>  \n\n\n\n\n\n      <\/a><\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #430 May 18, 2020 9:53 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10403","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10403","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10403"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10403\/revisions"}],"predecessor-version":[{"id":11579,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10403\/revisions\/11579"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10403"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}