As a fresh Covid-19 wave sounds alarm bells, CNN-News18 speaks to Dr Shyam Kukreja, senior director and head of the department (paediatric) at Max Super Speciality Hospital, to understand how the viral infection affects children, what the common symptoms among them are, what to watch out for, and when vaccination for children is expected to begin. Edited excerpts:
A year into the outbreak, what is our understanding of how Covid-19 affects children and teenagers?
….we have seen one wave in Delhi already; now we are into the second wave. In our experience, we have seen that children tend to get infected, but they are not severely affected. (Usually) they do not get the serious disease. During the second wave, Covid-19 effects on children are comparatively higher, yet not serious, though more symptomatic infections are observed.
The cause of concern is Multisystem Inflammatory Syndrome in Children (MIS-C), which is observed in case of children and occurs after two-six weeks (of the infection). Covid-19 is caused mainly due to immune system dysregulation. Luckily, MIS-C is rare — that is 1 in 100,000 — but we paediatricians are more aware and cautious about this.
(MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs, according to the US Centers for Disease Control and Prevention)
What are the learnings from the past year?
That children do get infected. They transmit the disease…The major concern is the transmission to elders, who are at a higher risk. Children are usually asymptomatic.
There is a widely held belief that children and teens are not at risk. What do you have to say?
During this wave, we have seen more serious cases. Fever lasts for a longer period. Symptoms such as fever, mild cough, tiredness, body ache, vomiting and diarrhoea are observed.
There are concerns for two groups of children. The first group is below the age of one year, and the second group is adolescents, particularly those who are obese. Any child may get severely affected if they have co-morbidity. If fever continues for three-four days, do consult doctors again.
Some say it is mostly the children and the young that are getting infected in the new wave. Is it true? If yes, why?
Adults, as well as children, both are at risk of infections. But in comparison to the last year, the number of symptomatic…patients, particularly in the case of children, has increased — due to which more cases are observed.
What are the most common symptoms among children and teens?
Most common symptoms are fever, sore throat, mild cough, tiredness — even 4-5 years old children complain of feeling tired and being lethargic — body ache, vomiting, diarrhoea. In general, children tend to start recovering after three days. If symptoms last beyond three days without any improvements, then those cases are of particular concern.
Are the new variants more threatening to kids?
Data indicates that it (the present situation) may be comparatively serious, but in practice, particularly in case of Delhi, observations only suggest that the infection is now more symptomatic. Is it more threatening? We are yet to see. It is to be noted that we have to differentiate and be cautious for Multisystem Inflammatory Syndrome (MIS-C), which is the major cause of concern and is to be treated with caution. Children tend to have shocks, heart involvement or heart-related problems. Multisystem Inflammatory Syndrome (MIS-C) occurs in rare cases and is observed…
Why have vaccination programmes kept children out of the ambit so far?
The emphasis of vaccination programmes was for the age group 40-45 years and above, as they generally have comorbidity and are affected very severely. This was the major area of focus because earlier children were (mostly) asymptomatic and the infections observed in children was mild in general.
When are vaccines for children expected?
Presently, vaccine trials for children are in progress and the data on these trials is awaited. Hopefully, a vaccine for children can be expected by early next year.