Multisystem inflammatory syndrome in children, abbreviated MIS-C, appears to be on the rise in the US. Aaron Milstone, a pediatric infectious disease expert at Johns Hopkins, says the syndrome may sneak up in unpredictable ways.

Milstone: We have a lot of people come in and they don’t understand why their kid is sick. And we say well was anyone sick a month ago? And they say ug, yeah, Covid ran through our house I was sick, my partner was sick, our other kids was sick and this child was fine, and here they are a month later in the hospital, in the intensive care unit. We’re trying to make it very clear that this MIS-C is a post infectious process. It’s associated with Covid, meaning that when kids come in we don’t think that they’re really at risk of spreading the virus at that point, they’ve already cleared the infection and now their body is just still going a little bit crazy responding to that prior viral infection.   :33

Milstone says seeking medical care promptly is important, so if you suspect your child may be exhibiting symptoms of MIS-C, bring them in right away. He notes that suspicions should definitely be raised if there’s been a history of Covid infection in the family. At Johns Hopkins, I’m Elizabeth Tracey.


MIS-C stands for multisystem inflammatory syndrome in children, and it’s on the rise in the US, recent data indicate. Aaron Milstone, a pediatric infectious diseases expert at Johns Hopkins, describes what’s known.

Milstone: This is a post-infectious phenomenon so kids can get Covid, they might even have an asymptomatic infection but then they present two, three four weeks after that with shock, and some of them have heart problems. They often will present with abdominal complaints like diarrhea, or severe abdominal pain. There have been teenagers that have very bad outcomes from this, even death. It’s not as common in younger kids but we are seeing younger kids now with this same post-infectious inflammatory syndrome.  :30

Milstone says parents must take the threat of Covid infection in their children seriously, as MIS-C is one possible consequence of infection. He notes that recent relaxation of many restrictions may result in many more cases, and urges parents to seek care if they suspect the syndrome. At Johns Hopkins, I’m Elizabeth Tracey.


When people say they won’t get a Covid-19 vaccine, that’s called ‘vaccine hesitancy,’ and while one person’s individual decision not to be vaccinated may not seem like much, since we need the majority of people to get the shot to protect us all, recent data suggesting that that number is declining is good news. Michelle Patch, assistant professor at the Johns Hopkins School of Nursing, has been helping vaccination efforts in the region.

Patch: Understandably I think a lot of individuals from various backgrounds have had a bit of worry about this. It seems to have happened very quickly, and so is it safe? Is it right for me? We know that those behind the scenes at FDA, CDC, have an emergency use authorization but that does not preclude all of the safety checks that need to happen.  :28

Most estimates say only about 25% of people remain unwilling to get the vaccine. At Johns Hopkins, I’m Elizabeth Tracey.


If you’ve been fully vaccinated, the Centers for Disease Control and Prevention recommend that travel is low risk. Yet Aaron Milstone, a pediatric infectious diseases expert at Johns Hopkins, says those guidelines don’t apply to children.

Milstone: The CDC came out and has given people the green light to travel if they’ve been vaccinated. For many of us that doesn’t include our kids who are under the age of 16. The premise of traveling with your kids is people have this perception that kids are not going to get Covid and are not going to get sick from Covid. We know that’s not true. I’ve encouraged people, as they ponder traveling, which we all want to do, we’re all ready to get out, to remember that our kids are still susceptible, and although they aren’t as high risk as our grandparents there is risk.  :30 

Milstone notes that infection rates around the country are once again rising, and many younger people are becoming infected. He says keeping our children safe relies even more on masks and other measures until a vaccine for them becomes available. At Johns Hopkins, I’m Elizabeth Tracey.


Sars-CoV2 variants are spreading apace around the US and the world, even as scientists race to assess whether currently available vaccines will provide protection against them. Brian Garibaldi, a critical care medicine expert at Johns Hopkins, says the presence of variants is not his primary concern.

Garibaldi: With the variants right now, I’m not worried about the ones that are circulating in terms of preventing us from being safe if you’ve been vaccinated, but the longer we allow high levels of community circulation of this virus, the more likely it is that there is going to be a variant that eventually is going to emerge that is going to start infecting people at a higher rate who have been vaccinated, and then we’re going to have to start the process all over again. And I think having this degree of community spread in our country but also if you look at what’s happening in India and Brazil, those are going to be hotbeds of variants if we don’t get things under control.  :31

The advice remains to keep up distancing, masks, and avoiding crowds, Garibaldi notes, and getting vaccinated as soon as possible. At Johns Hopkins, I’m Elizabeth Tracey.


Everywhere you look it seems more people are being infected with the coronavirus, with hospitalizations also rising around the US and the world. Brian Garibaldi, a critical care medicine expert at Johns Hopkins, says weariness is pervasive.

Garibaldi: I’m disappointed. Everyone’s tired. Everybody’s tired of not doing the things you want to do. Spring is here and you want to go out, you want to do the things you’re used to doing in the spring. You want to be with your friends, you want to be at large gatherings, you want to be at holidays. And I think we’re seeing those effects with what’s happening with the numbers. Obviously every state is a little bit different but the majority of states are reporting an increase in cases, an increase in hospitalizations. An increase in ICU level care, the numbers are going straight up again. What we don’t yet know is at what point we’re going to temper that with the benefits of the vaccine.  :30

Garibaldi notes that the recent pause of the J and J vaccine will inevitably slow down the pace of immunizations, and provide an opportunity for additional spread of the virus. At Johns Hopkins, I’m Elizabeth Tracey.


Alzheimer’s disease now joins the list of conditions associated with greater risk when it comes to Covid-19, a recent study demonstrates. Brian Garibaldi, a critical care medicine expert at Johns Hopkins, explains why that might be so.

Garibaldi: In general people who have dementia or advanced neurological illness oftentimes they will end up having problems protecting their airways following having recurring infections, pneumonia. Part of it could be related to, if you look at our initial population who got admitted from nursing homes about half of them had dementia. We know that that was a high risk group independent of dementia living in a nursing facility or being in that environment, particularly early on that was a risk for severe disease and even death. There’s also speculation that people with dementia are less able to report their symptoms.  :31

For now Garibaldi says the data clearly point to the need to protect those with Alzheimer’s disease and other forms of dementia from being infected with the coronavirus, and to vaccinate as soon as possible. At Johns Hopkins, I’m Elizabeth Tracey.