Children, like adults, can develop life- threatening myocarditis, which is an inflammation of the myocardium, the middle layer of the heart wall.

Since symptoms are similar to those of many other childhood diseases, it is usually not diagnosed immediately, noted Hermann Josef Kahl, a paediatric cardiologist and member of Germany’s Professional Association of Children’s and Young People’s Physicians.

“Another illness often precedes myocarditis by several weeks, usually viral and more seldom bacterial,” Kahl said.

Symptoms of myocarditis include sudden fatigue, night-time fever and sweating for no apparent reason, rapid heartbeat, shortness of breath and vague chest pains, Kahl said. Stomach-ache and nausea are also fairly common, and sometimes the affected children lose weight.

Paediatric cardiologists can prevent complications in about two- thirds of the cases by recognizing and treating myocarditis early, after which the inflammation subsides within two or three months.

However, some 20 to 30 per cent of the children who develop the disorder suffer permanent and sometimes life-threatening heart damage. In very severe cases they can require a heart transplant.

Cases of myocarditis generally increase after influenza epidemics.

Other illnesses that can trigger myocarditis are measles, mumps, rubella, chicken pox, and streptococcal infections such as strep throat and scarlet fever.

“Newborns are particularly at risk because their immune systems are not yet fully developed. The danger of sudden cardiac death is highest at this age,” Kahl said.

He advised parents of an infant that refuses nourishment, is sweaty, pale and has bluish hands and feet to seek medical help without fail.

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