first confirmed case of pims-ts in australia emerged (from victoria) on 4 september, along with news of other suspected cases under review. in south korea, news of two confirmed cases broke on 5 october (and the existence of a case dating back to the end of april was reported in november). a similar condition began to be recognized in some adults. in june, an adult case of a kawasaki-like multisystem inflammatory syndrome following sars-cov-2 infection was described in a 54-year-old woman from israel with no history of autoimmune disease, who experienced uveitis in both eyes. (a further suspected adult case was covered in the israeli national press.) a case involving a 36-year-old hispanic american woman with clinical features otherwise consistent with mis-c was reported from new york. a diagnosis consistent with pmis was also reported in a uk-born, 21-year-old man of somali origin. a case report published in the lancet regarding a 45-year-old hispanic man who presented in new york with features strongly resembling mis-c called for awareness of "a potential mis-c-like condition in adults." further reports of multisystem inflammatory syndrome linked to covid-19 exposure emerged in adults. in october, the cdc reported on the condition and named it 'multisystem inflammatory syndrome in adults' (mis-a). questions have been raised regarding possible relationships between mis-c and certain severe manifestations of covid-19 in adults. children's neurological symptoms, as studied in london in mid-2020, often involved "both the central and peripheral nervous systems," according to a report by the american academy of neurology released on 13 april 2021. explanatory notes given that hospital case series can be selected on the basis of clinical factors such as presence of heart failure or admission to intensive care units, available statistical information regarding the frequencies of different clinical features may be skewed by selection bias. in the state of new york, about 2 out of 100,000 individuals under 21 years of age are thought to have been affected in conjunction with the covid-19 epidemic there (with the numbers of new cases peaking 31 days after the local peak in viral infection). a nationwide surveillance programme in france, set up to investigate the temporal relationship between sars-cov-2 infection and pmis, revealed that 95 of the 156 cases of kawasaki-like disease notified between 1 march and 17 may 2020 were "confirmed or probable post-covid-19 cases", with a peak in incidence 4–5 weeks after the peak of the covid-19 epidemic in the country. clinicians in bergamo, italy, reported an apparent (not seasonally adjusted) 30-fold increase in the incidence of kawasaki-like disease during the first six weeks after the arrival there of sars-cov-2 virus infection, at a time when bergamo was experiencing the highest rates of infections and deaths in italy. in the uk, the number of intensive care admissions for children fulfilling the rcpch case definition of pmis during 40 days through april and early may, following the first national surge in covid-19 cases, was at least 11-fold higher than historical trends for paediatric inflammatory conditions. time series analysis of cases of kawasaki disease admitted to a paediatric centre in paris, france, revealed a spike that started 2 weeks after the first peak of the covid-19 epidemic there, corresponding to a roughly 5-fold increase in incidence. these cases from paris had a similarly severe clinical profile to those reported in bergamo (and differed from the more typical kawasaki disease profile observed in a newly uncovered spike following the peak of the 2009 h1n1 swine flu epidemic in paris). no apparent rise in new cases of kawasaki disease was noted in these countries, including in south korea (where one diagnosis was subsequently reclassified as mis-c), and in singapore. there had been no report of kawasaki disease or kawasaki-like symptoms in mainland china. an extensive latin-american kawasaki disease surveillance network (rekam-latina) has recorded cases of mis-c across all its participating countries. some other countries where cases have been reported include russia, india, pakistan, kazakhstan, south korea, turkey, iran, saudi arabia, israel, algeria, south africa, and australia.