Multisystem Inflammatory Syndrome in Children (MIS-C) While children generally experience mild symptoms with COVID-19, a possible link has been found between COVID-19 and a serious inflammatory disease in some children and teenagers who have current or recent infections. The first reports of this syndrome came from the United Kingdom in late April 2020. Cases in the United States were first reported in New York City in early May 2020. NCDHHS has requested reporting of suspected cases of MIS-C from all health care providers. The Department is also monitoring for possible cases using existing surveillance systems and will include this in the weekly surveillance report going forward. MIS-C is a very rare condition, but as COVID-19 cases increase, additional reports of MIS-C could follow. Because children with this syndrome may become seriously ill, it is important that parents and caregivers know the signs and symptoms their children may have, so they can get help right away. Most children with MIS-C have fever (temperature of 100.4 degrees F or 38.0 degrees C or greater) lasting several days, along with other symptoms. Other common symptoms include: Irritability or decreased activity Abdominal pain without another explanation Diarrhea Vomiting Rash Conjunctivitis (red or pink eyes) Poor feeding Red, cracked lips or red, bumpy tongue that looks like a strawberry Swollen hands and feet, which might also be red Call your child’s doctor immediately if your child has a persistent fever plus any of the above symptoms. The doctor will ask about your child’s symptoms and use that information to recommend next steps. If your child is severely ill, go to the nearest emergency room or call 911 immediately. MIS-C is not contagious, but children with these symptoms could have COVID-19 or another infection that may be contagious. Parents and caregivers should take precautions to prevent spread, and health care providers will use infection control precautions when treating your child. Information about MIS-C cases in North Carolina will be updated each week in the surveillance summary on the NCDHHS COVID-19 website and data will be shared with the CDC to help track MIS-C nationally. Additional information will be shared as more is learned about this condition. For more information on MIS-C related to COVID-19, visit the CDC website at https://emergency.cdc.gov/han/2020/han00432.asp.