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NEW: Kawasaki-like syndrome now reported in 15 states. Based on publicly-available data, the United States case count is at least 164, including: New York (102), New Jersey (18), Massachusetts (8), Connecticut (6), Illinois (6), California (4), Delaware (3), Georgia (3)...
Louisiana (3), Washington D.C. (3), Kentucky (2), Ohio (2), Pennsylvania (1), Utah (1) Washington state (1), and Mississippi (1).
CDC is preparing to release an alert warning doctors to look for a potentially-lethal inflammatory syndrome in children that could be linked to coronavirus. CDC will also release a working case definition, which does not yet exist: 
cnn.com/2020/05/13/hea…
A note on the count: Some hospitals are reporting "a few" cases, which I have counted as 2 cases. Several states have not yet revealed the number of cases, which I count as 1 case. The number 164 almost certainly represents an undercounting of total cases in the United States.
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Matt McCarthy
@DrMattMcCarthy
NEW: Case definition for Kawasaki-like syndrome created based on 102 children in New York. First standardized criteria for a condition that is being called pediatric multi-system inflammatory syndrome: Image
Clinical definition: 1) Fever, 2) Hospitalization, and 3) One or more of: Shock/Cardiac illness/Severe organ damage (excluding lung disease) OR 4) Two more more: rash, conjunctivitis, GI symptoms, mucocutaneous inflammation.
Lab criteria: 2 or more: Neutrophilia, lymphopenia, thrombocytopenia, hypoalbuminemia,☝️CRP/ESR, fibrinogen, D-Dimer, ferritin, lactic acid, LDH, IL-6, OR elevated procalcitonin. And: Detection of: 1) #Coronavirus RNA at hospitalization (or within prior 4 weeks) or 2) antibody.
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Matt McCarthy
@DrMattMcCarthy
NEW: Gov. Cuomo announces there are now 93 children in New York with Kawasaki-like syndrome potentially linked to #coronavirus. Medical directors of foster care agencies have been notified. Formal diagnostic criteria do not yet exist and link to COVID has not been established.
Parents should be on the lookout for following symptoms in children:
1. Persistent fever
2. Abdominal pain (often severe), vomiting, diarrhea
3. Bilateral red eyes/conjunctivitis
4. Red, cracked lips or red tongue
5. Rash that develops over the body and can reach extremities
6. Swollen hands with peeling of the skin
7. Enlarged lymph nodes on the side of the neck

Most children with this illness are not presenting with respiratory symptoms typically associated with COVID-19.
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Matt McCarthy
@DrMattMcCarthy
I began studying pandemics in 2003, when I joined Peter Daszak’s research team👇. I traveled to Africa to help answer the question: Where does Ebola go between outbreaks? The virus would destroy a village, killing hundreds, then it would disappear for decades. Where did it go?
Daszak had a hunch; our group went to Cameroon to find Ebola. We traveled into the bush, tracking the flight pattern of bats. My job was to scurry up a hill or climb a tree to place a net in their flightpath. We caught hundreds🦇& sent their blood to the U.S. for analysis.
Our group & others discovered that bats were harboring deadly viruses, including Ebola. From our work, we knew that the next pandemic would likely emerge from a bat. I interviewed Daszak five years ago & he mentioned the dangers of Chinese meat markets: slate.com/technology/201…
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