5 Facts About Kawasaki Disease

Ridofranz, iStock via Getty Images
Ridofranz, iStock via Getty Images

While most pediatric COVID-19 cases are mild, the disease has been tied to a serious new syndrome in kids. In recent weeks, dozens of children who tested positive for COVID-19 antibodies have exhibited symptoms like rash, fever, diarrhea, and swollen hands and feet—all signs similar to a rare condition called Kawasaki disease. Like Kawasaki disease, the mystery illness, officially known as pediatric multi-system inflammatory syndrome (PIMS), can lead to severe heart issues. In New York, three children have died from it.

Medical experts still aren’t sure how this condition develops, or how it’s related to COVID-19. Here are five things we do know about Kawasaki disease, the syndrome it resembles.

1. Symptoms of Kawasaki disease appear in phases.

When patients first contract Kawasaki disease, the most serious symptom is a high fever that lasts five days or more. Other diagnostic signs that appear in this first stage include chapped lips, bloodshot eyes, sore throat, swollen hands and feet, and a rash covering the back, limbs, belly, and groin. These symptoms are the result of inflammation in the arteries, veins, capillaries, and lymph nodes.

After experiencing a fever for about two weeks, patients may enter the second stage of the disease. This phase is characterized by diarrhea, vomiting, joint pain, and temporary hearing loss. Peeling skin on the hands and feet is another symptom, with dead skin sometimes coming off the extremities in layers.

The third phase is known as the convalescent phase, and it comes about four weeks after the fever first develops. During this period, which can last a couple of weeks, patients gradually recover and their symptoms improve.

2. Kawasaki disease can have deadly complications.

Most children who get Kawasaki disease fully recover, and recovery rates are even higher when the disease is caught early. But in some cases, the illness has dangerous effects on the cardiovascular system. The inflammation that characterizes the disease can weaken artery walls, resulting in rare cases of heart disease and heart attacks in children. Heart problems afflict about a quarter of Kawasaki disease patients who didn’t receive early treatment for the condition. Of these untreated cases, roughly 2 to 3 percent are fatal.

3. Kawasaki disease is uncommon.

Kawasaki disease is rare, effecting roughly 4200 children in the U.S. annually. The syndrome is almost exclusive to kids, with most cases occurring in patients younger than 5 years old. It’s 1.5 times more common in boys, so sex may factor into who gets it. Ethnicity is another possible component: Kawasaki disease rates are 10 to 20 times higher in East Asian countries like Korea and Japan than in the U.S.

4. Kawasaki disease is often treated with an over-the-counter drug.

One of the primary treatments for Kawasaki disease is aspirin. The anti-inflammatory drug can help relieve pain, reduce fever, and prevent blood clots in kids with the condition. Aspirin shouldn’t be taken by children for other types of fever or pain, though, due to the risk of a serious condition called Reye's syndrome. Kawasaki disease is the rare instance when aspirin is given to kids, and even in these cases, it should only be taken under the supervision of a doctor.

The other main treatment for the disease is intravenous immunoglobulin, or IVIG. Immunoglobulin is a solution of antibodies from healthy donors that helps boost the patient's immune system to fight disease. It’s administered through the patient’s vein, and if given early enough, it can reduce symptoms within 36 hours.

5. COVID-19 may trigger Kawasaki disease, but it's too soon to tell.

Doctors are unclear on what causes Kawasaki disease. One theory is that antigens found in some viruses can trigger a hyper-inflammatory response in children who are genetically susceptible. This is similar to what's being observed in the new pediatric multi-system inflammatory syndrome, which is possibly related to COVID-19. "We think patients were exposed to the SARS-CoV-2 virus, they may or may not have had some symptoms, and later on there was a delayed reaction," Michael Portman, pediatric cardiologist and director of the Kawasaki Disease Clinic at Seattle Children’s, says of the recent PIMS cases. "There was a hyper-inflammatory response launched by the body against the viral antigen, so that fits with the main hypothesis for Kawasaki disease."

More research still needs to be done to understand the relationship between PIMS and COVID-19. "It's a little bit early to make a direct link, but it seems plausible that the new coronavirus does trigger an immune response that could result in Kawasaki disease, or a different spectrum of the disease, or even a separate disease that we're calling PIMS," Portman tells Mental Floss.

It's also too early to say definitively that PIMS and Kawasaki disease are the same thing, but to experts who have studied the latter, the new syndrome looks very familiar. "It is very difficult to separate the two," Portman says. "They are very, very similar, and it's going to take quite a bit of research to determine if they're different."

12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

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7 Overlooked Thanksgiving Rituals, According to Sociologists

Even what the dog eats takes on a special significance on Thanksgiving.
Even what the dog eats takes on a special significance on Thanksgiving.
JasonOndreicka/iStock

The carving of the turkey, the saying of the grace, the watching of the football. If a Martian anthropology student asked us to name some cultural rites of Thanksgiving, those would be the first few to come to mind. But students of anthropology know that a society is not always the best judge of its own customs.

The first major sociological study of Thanksgiving appeared in the Journal of Consumer Research in 1991. The authors, Melanie Wallendorf and Eric J. Arnould, conducted in-depth interviews with people about their experiences of the holiday. They also had 100 students take detailed field notes on their Thanksgiving celebrations, supplemented by photographs. The data analysis revealed some common events in the field notes that people rarely remarked on in the interviews. Here are some common Thanksgiving rituals you might not realize qualify as such.

1. Giving Job Advice

Teenagers are given a ritual status shift to the adult part of the family, not only through the move from the kids' table to the grownup table, but also through the career counseling spontaneously offered by aunts, uncles, and anyone else with wisdom to share.

2. Forgetting an Ingredient

Oh no! Someone forgot to put the evaporated milk in the pumpkin pie! As the authors of the Thanksgiving study state, "since there is no written liturgy to insure exact replication each year, sometimes things are forgotten." In the ritual pattern, the forgetting is followed by lamentation, reassurance, acceptance, and the restoration of comfortable stability. It reinforces the themes of abundance (we've got plenty even if not everything works out) and family togetherness (we can overcome obstacles).

3. Telling Disaster Stories of Thanksgivings Past

One day she'll laugh about this.cookelma/iStock

Remember that time we fried a turkey and burned the house down? Another way to reinforce the theme of family togetherness is to retell the stories of things that have gone wrong at Thanksgiving and then laugh about them. This ritual can turn ugly, however, if not everyone has gotten to the point where they find the disaster stories funny.

4. The Reappropriation of Store-Bought Items

Transfer a store-bought pie crust to a bigger pan, filling out the extra space with pieces of another store-bought pie crust, and it's not quite so pre-manufactured anymore. Put pineapple chunks in the Jello, and it becomes something done "our way." The theme of the importance of the "homemade" emerges in the ritual of slightly changing the convenience foods to make them less convenient.

5. The Pet’s Meal

The pet is fed special food while everyone looks on and takes photos. This ritual enacts the theme of inclusion also involved in the inviting of those with "nowhere else to go."

6. Putting Away the Leftovers

These leftovers will make delicious soup.smartstock/iStock

In some cultures, feasts are followed by a ritual destruction of the surplus. At Thanksgiving, the Puritan value of frugality is embodied in the wrapping and packing up of all the leftovers. Even in households in which cooking from scratch is rare, the turkey carcass may be saved for soup. No such concern for waste is exhibited toward the packaging, which does not come from "a labor of love" and is simply thrown away.

7. Taking a Walk

After the eating and the groaning and the belly patting, someone will suggest a walk and a group will form to take a stroll. Sometimes the walkers will simply do laps around the house, but they often head out into the world to get some air. There is usually no destination involved, just a desire to move and feel the satisfied quietness of abundance—and to make some room for dessert.