Boy, 4, with MIS-C went from general ward to ICU within a day

More than three weeks after four-year-old Muhammad Ali Zafir Mohamed Azmi recovered from Covid-19, he started having a high fever and chills one evening. Two days later, he started vomiting as well.

This got his parents worried and he was taken to KK Women's and Children's Hospital (KKH) on Nov 1, where he was admitted.

The boy's condition deteriorated so rapidly that within a day, he was transferred from a general ward to a high dependency ward and then the intensive care unit (ICU), where he had to be intubated, his mother, Ms Marilyn Cacanindin, told The Straits Times yesterday.

Doctors diagnosed him with multi-system inflammatory syndrome in children (MIS-C), a rare and severe condition that affects children who were infected with Covid-19.

He is one of four cases of MIS-C that emerged from some 8,000 Covid-19 paediatric cases, said the Ministry of Health last Saturday.

The cause of MIS-C remains unknown, but paediatric immunologist Liew Woei Kang told ST that it is frequently seen after recent Covid-19 infection and hence thought to be a post-infectious immune phenomenon.

Ali Zafir had recovered from a bout of Covid-19 in September and was placed on home recovery from Sept 24 to Oct 6. He returned to school only on Oct 18 out of an abundance of caution.

For around three weeks, Ali Zafir was back to his bubbly and energetic self, eagerly playing his favourite game - Call Of Duty - with his siblings.

So his parents were blindsided when, after seemingly leaving the coronavirus behind, he started having a fever on Oct 29 at around 6.45pm.

Ms Marilyn did an antigen rapid test (ART) on the boy. The result was negative, so she left him to rest at home and went to work.

Ms Marilyn, 39, works as a manager at fast-food chain McDonald's, while her husband, Mr Mohamed Azmi Lendang, 48, is an audio-visual technician at Marina Bay Sands.

They live with their four children, aged one to nine, and their domestic helper in Kaki Bukit.

"We thought he was (having chills) because of a normal fever, so we let him rest and gave him (fever medication) ibuprofen," said Ms Marilyn.

However, the fever and chills persisted and he began vomiting on Oct 31. Her husband took the boy to KKH the next day.

Ali Zafir was given 12 different medications, intubated and placed on a ventilator for one week till Sunday.

"When he had to be intubated, he kept crying and shouting for me - he didn't want to let me go, but I had to (go)," said Ms Marilyn, who took care of him in the ICU but had to leave the room during the intubation.

"Both my husband and I were worried about his young body going through so much pain, with needles in him."

Although the boy still remains in the ICU, he has shown many signs of improvement after being taken off the ventilator. He can now raise his arms and sit up with some struggle, aided by nurses and physiotherapists, though he cannot stand up yet.

Ms Marilyn said Ali Zafir tested positive for Covid-19 on Sept 24, two days after her father, who is fully vaccinated, tested positive.

Subsequently, Ms Marilyn, Mr Azmi and their two elder children - a boy, eight, and a girl, nine - also tested positive, but all recovered without much incident. Their domestic helper and youngest child, aged one, were not infected.

Ms Marilyn said her son has faced his pain with much bravery.

SALUTE

She is grateful to the hospital staff: "I salute all the doctors and nurses. They love Ali and really take care of him.

"The nurses understand how it's painful for him... They've been praising Ali for being so brave, never struggling as they check him."

KKH declined comment about Ali Zafir's case, citing patient confidentiality.

Ms Marilyn is also grateful to her boss for giving her time off to deal with the situation, and Ali Zafir's pre-school principal, who got the family extra ART kits when they ran out.

She told ST that she is sharing her experience to highlight the need for parents to look out for potential MIS-C symptoms in children who have recovered from Covid-19.

These include persistent fever above 38.5 deg C for three days or more, with difficulty breathing, headache, neck swelling, rash, swollen hands and feet or abdominal pain.

She also shared her experience on Facebook last Tuesday, in a post that has gathered over 400 likes.