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Kentucky Department for Public Health Message: COVID-19 Pediatric Multi-System Inflammatory Disorder, Jan. 22, 2021

Healthcare and clinical organizations:  Please distribute the following message and attachments to your constituents in the method you deem appropriate.

Dear Clinicians:

During the COVID-19 pandemic we have documented 24 cases of COVID-19 multisystem inflammatory disorder in children (MIS-C) in Kentucky residents, and several more in out-of-state residents.  No deaths have been documented, thankfully, but we want to remain vigilant in detecting potential new cases.

In pursuit if this, please find attached several documents that should be useful for this purpose.

1) Two informational flyers with the basic information about how to identify potential MIS-C cases.  These documents are identical other than the pictures at the top – one targets infants and the other older children.  MIS-C is defined as < 21 years old.

2) The CDC MIS-C Case Report Form

3) Kentucky’s EPID 200 Disease Report Form

We ask that you report potential cases of MIS-C to the Kentucky Department for Public Health using the two attached report forms.  The CDC MIS-C Report Form collects detailed information on the MIS-C event itself.  The EPID 200 form collects general information on the patient, such as demographics and basic disease information.  Note: You do not need to duplicate information on the EPID 200 that is already included on the CDC MIS-C Case Report Form – just make sure to fill out the MIS-C form as completely as possible and add any additional requested information on the EPID 200 form.

To submit report forms for a potential MIS-C case, please send both the CDC MIS-C Case Report Form, and the EPID 200 Disease Report Form to our Reportable Disease Secure Fax at: 502-696-3803 (shown on the bottom of P. 2 of the EPID 200 form), ATTN: MIS-C.

For questions or clarification, please contact Reportable Disease Nurse Stacy Davidson at 502-564-3261 x4238 or

Thank you for your attention to this clinical alert and for all of your hard work in responding the COVID-19 pandemic in so many ways!


Doug Thoroughman, PhD, MS
State Epidemiologist (Acting)
CDC Career Epidemiology Field Officer
Kentucky Department for Public Health
275 E. Main St., HS 2GW-C
Frankfort, KY 40621
Phone: 502-564-3418 x4315
Fax: 502-564-9626