Two months ago, as passengers evacuated from the Grand Princess cruise ship in Oakland but before the Bay Area issued any stay-at-home orders, the mystery was unfolding in Santa Clara County
Six-month-old baby Zara had high fever.
“It was a regular morning,” remembered her mother Mahera. “It was March 10th and we woke up and she was hot.”
Mahera called the pediatrician, who came to one conclusion quickly.
“They ruled out COVID-19, because there is no travel history or anything like that,” said Mahera.
As Zara’s fever persisted, she also developed a horrible rash, red eyes and dry, chapped lips.
Her mother brought her to the urgent care center at the Sutter Health Palo Alto Medical Foundation in Mountain View.
Palo Alto Medical Foundation Dr. Evie Huang examined the baby.
“She was crying pretty much the entire exam and even when mom was holding her to her chest, she was hard to calm,” said Dr.Huang. “She did have a pretty significant rash all over her body; from, you know, her chest, arms, legs. All the way down”
Dr. Huang suspected Kawasaki disease, a rare illness that causes blood vessels to be inflamed, most commonly in young children.
“That’s why I admitted her to the hospital, initially; for treatment for Kawasaki,” said Dr. Huang.
Zara was treated at Lucile Packard Children’s Hospital Stanford. Since she had a fever, it was protocol to test her first for COVID-19.
“No this is not COVID-19, because there is no possibility. I was keeping her safe,” said Mahera.
But then they got the results. Zara tested positive for coronavirus.
“I was shocked. I was pretty definitely shocked. Like how is this possible?” said Dr. Huang.
“I was surprised. And a little bit apprehensive about walking into the hospital and caring for a patient who was the first patient at Stanford Children’s to test positive for COVID-19,” Dr. Veena Jones, the pediatric hospitalist in charge of Zara’s care.
While there is no known cause for Kawasaki, it may be triggered by a virus. Which raises the question: could it be caused by COVID-19?
“I can tell you it’s possible that the virus triggered the Kawasaki disease. But I can’t tell you definitively,” said Dr. Jones.
In the hospital, the baby was successfully treated with IV-administered anti-inflammatories, getting rid of her fever, rash and red eye.
“I was pleased to see that she actually looked quite well,” said Dr. Jones.
But since baby Zara tested positive for COVID-19, she would need to be isolated,
“How do we safely discharge her home?” asked Jones.
Both Zara and her mother would be quarantined for 14 days.
“We tried to be brave and positive,” said Mahera.
They succeeded. No one else in the household ever tested positive. But the mystery of how Zara was infected remains.
Zara’s case is now part of medical history. Dr. Jones and her colleagues wrote a report to alert other clinicians of the possible connection between COVID-19 and Kawasaki disease.
Zara’s mom offered a message about the pandemic: It’s not over. Stay home and be safe.
“Love your kids. Hug your kids. They are your world. Just take it seriously,” said Mahera.