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07 Nov 2021

6th Nov 2021

The Ministry of Health (MOH) has been notified of four cases of paediatric Multi-system Inflammatory Syndrome in Children (MIS-C) to date. These four cases were amongst the over 8,000 paediatric COVID-19 cases in Singapore since the start of the pandemic, and considered rare. Of these four cases, one is in the Children’s Intensive Care Unit (CICU), one is in a General Ward, and two have been discharged.

2. The four cases are:

a. A three-year-old boy admitted to the National University Hospital (NUH) CICU on 16 October 2021. He had repeatedly tested PCR-negative, but his serology test results indicated that he likely had a COVID-19 infection two to six weeks prior to the development of MIS-C. He has since recovered and was discharged on 23 October.

b. An eight-year-old boy admitted to KK Women’s and Children’s Hospital’s (KKH) CICU on 27 October 2021. He had been previously diagnosed with COVID-19 infection on 30 September. He has since recovered and was discharged on 1 November.

c. A four-year-old boy admitted to KKH CICU on 1 November 2021. As of 6 November, the boy remains in the CICU and his breathing is supported by mechanical ventilation. He had previously tested positive for COVID-19 infection on 24 September. The KKH paediatric teams are actively managing his care.

d. A two-month-old female infant admitted to KKH General Ward on 3 November 2021. She was previously admitted to KKH for COVID-19 infection on 12 October, and discharged on 19 October. The patient’s condition remains stable, with no oxygen requirements.

3. In May 2020, an international review from 26 countries reported a MIS-C incidence of 0.14% (14 in 10,000) among all children with COVID-19 infection. 

4. MIS-C is similar in presentation to Kawasaki Disease (KD) which has been linked to various virus or bacterial infections, and occurs in 150 to 200 children a year in Singapore. Symptoms of MIS-C include persistent fever above 38.5°C for three days or more, with difficulty breathing, headache, neck swelling, rash, swollen hands and feet, conjunctivitis, diarrhoea, or abdominal pain.

5. As MIS-C is linked to previous COVID-19 infection, measures such as mask wearing, hand hygiene, and safe distancing measures remain important to reduce the risk of contracting COVID-19 infection.