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Doctors at the Hospital for Sick Children in Toronto, shown here April 5, 2018, are examining an estimated 20 possible cases of the mysterious inflammatory syndrome linked to COVID-19.The Canadian Press

Doctors in four provinces are now investigating cases of a mysterious syndrome in children that is believed to be linked to the coronavirus, but the suspected Canadian cases have not been as severe as those reported in New York and London, where a handful of children have died.

Alberta’s Chief Medical Officer of Health announced Wednesday that doctors are looking into one suspected case in the Calgary health region, while British Columbia is investigating at least six cases.

The Hospital for Sick Children in Toronto and Sainte-Justine Hospital in Montreal are examining an estimated 20 possible cases each.

“It’s still pretty rare," said Jeremy Friedman, the associate chief of pediatrics at SickKids. “The children, particularly the ones where I’ve been personally involved in their care, have actually not been that sick. That’s a bit of a different message from when I first read the reports from New York and London.”

Hundreds of children in New York and Europe have been sickened by the baffling new multisystem inflammatory syndrome, which features the overlapping symptoms of toxic shock, upset stomach and Kawasaki disease, a rare childhood illness that inflames blood vessels, most dangerously in the heart.

Pediatricians in London first alerted the world to the syndrome in late April. Not long after, New York, Italy, Spain and other places hit hard by the novel coronavirus began reporting similar cases, sometimes in children who tested positive through nasal swabs for active infections of COVID-19.

In other cases, blood tests found children had antibodies to the coronavirus, meaning they had been infected with the virus in the past.

In Canada, doctors are still trying to determine what connection the local cases might have to the coronavirus – a task that is proving difficult because antibody tests are not yet available, despite Health Canada having approved two such tests.

Dr. Friedman of SickKids said laboratories in Canada are working feverishly to verify the accuracy of the antibody tests, which have sometimes been unreliable in countries that rushed them into the field.

“I’d rather that we had a test we could rely on, even if it is a bit delayed, than jump to a test [where] we might be acting on faulty information," he said.

Blood samples have been drawn from the approximately 20 children identified as possible cases at SickKids over the past three or four weeks, Dr. Friedman added. Despite none testing positive for an active coronavirus infection, he expects many will be positive for coronavirus antibodies.

Deena Hinshaw, Alberta’s Chief Medical Officer of Health, said Wednesday that while little is known about the illness, it appears the inflammatory syndrome related to COVID-19 shows up several weeks to a month after a child or adolescent is infected with the coronavirus. "Typically, a child who has this particular syndrome, would not be considered – again, for what we know right now – to be infectious or infected with COVID at that point.

“It seems to be more something that happens as a result of their immune system going into overdrive after an infection and causing this inflammatory response in multiple organs.”

Dr. Hinshaw said the child being treated in Alberta is in stable condition in hospital.

On Monday, B.C. Provincial Health Officer Bonnie Henry said at least six cases of the syndrome were under investigation in her province.

In Montreal, Marie-Paule Morin, a pediatric rheumatologist at Sainte-Justine, agreed with Dr. Friedman that the cases she and her Canadian colleagues have seen so far have been less severe than the frightening reports in other countries. Only two of Sainte-Justine’s suspected cases required treatment in the intensive-care unit, Dr. Morin said Wednesday, and none tested positive for an active coronavirus infection.

No Canadian children are known to have died of the illness.

With a report from Carrie Tait in Calgary

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