May 18, 2020

On May 14, 2020, the Centers for Disease Control and Prevention (CDC) distributed a health advisory describing Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19).

The Department requests that health care providers report persons who meet the case definition for MIS-C to their county health departments (www.floridahealth.gov/chdepicontact). Please include medical records that provide documentation of each element of the case definition.

Case Definition for MIS-C:

• An individual aged <21 years presenting with fever1, laboratory evidence of inflammation2, and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological);
• No alternative plausible diagnoses; AND
• Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms

1 Fever >38.0°C for ≥24 hours, or report of subjective fever lasting ≥24 hours
2 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

Additional Comments

• Some individuals may fulfill full or partial criteria for Kawasaki disease but should be reported if they meet the case definition for MIS-C
• Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection