BOSTON — Massachusetts is a hot spot for a rare but severe disease in children that is linked to COVID-19.

The state is one of four with a high number of cases of pediatric multi-system inflammatory syndrome, according to the U.S. Centers for Disease Control and Prevention. The illness was first detected several months ago.

As of Friday, Massachusetts had reported 44 cases, at least 35 of which have been confirmed, according to the state Department of Public Health.

New York reported the highest number of cases, 240 as of Friday, and two deaths, according to health officials. New Jersey, another hot spot, has reported 55 cases. Maryland has reported 34 cases and one death.

Medical experts say states harder hit by the initial outbreak of the coronavirus are now reporting more cases of the childhood disease, because the new illness is a post-infection complication of COVID-19.

"Massachusetts was one of the first states to have a peak of COVID-19 infections, so it's not surprising that we have such a high number of cases compared to other parts of the country," said Dr. Vandana Madhavan, medical director of the pediatric infectious disease program at Massachusetts General Hospital.

In May, state health officials issued an advisory to health care providers requiring screening and mandatory reporting of suspected cases.

Symptoms of the new illness are similar to Kawasaki disease and in some cases can be severe. They include fever, rash, swelling of hands and feet, abdominal pain, diarrhea, as well as inflammation of the mouth, lips and throat. It also has symptoms similar to toxic shock syndrome, which can be fatal.

Many children infected with COVID-19 don't have symptoms, which experts say makes it difficult to detect who might be at risk for the new illness.

Most cases of the new illness so far have occurred in children between the ages of 1 and 14, according to the CDC. The Hispanic and Black communities are disproportionately affected, accounting for about 70% of the cases.

In Massachusetts, which was an early national hotspot for the coronavirus, COVID-19 infections, deaths and hospitalizations have been declining since a peak in May and June.

Medical experts suggest that will mean fewer cases of the new inflammatory illness showing up in emergency rooms in the long run.

Much like the rest of the country, children in Massachusetts have been spared the worst of the COVID-19 outbreak. Of more than 107,683 COVID-19 positive test results as of Friday, only 6,577 were in patients age 19 or younger. There have been no COVID-19 pediatric deaths in Massachusetts, either.

Last Friday, Gov. Charlie Baker noted that overall infections of people 30 and younger are declining in Massachusetts, even as they rise elsewhere.

He said that suggests young people are heeding the advice of public health officials to wear masks and socially distance.

"They've done a really good job of reducing the overall positive test rate," Baker told reporters at a briefing.

Christian M. Wade covers the Massachusetts Statehouse for The Salem News and its sister newspapers and websites. Email him at cwade@cnhi.com.

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