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Los Angeles County’s health department confirmed another four cases of multisystem inflammatory syndrome in children Friday, bringing the countywide total to 49.

The first and only confirmed death in the county related to the inflammatory condition was reported earlier this month.

The child who died had a “complex, preexisting cardiac condition” and suffered MIS-C complications, Children’s Hospital Los Angeles said at the time.

Multisystem inflammatory syndrome, which is referred to as MIS-C, is a rare but serious complication associated with COVID-19.

It causes a persistent fever and inflamed body parts, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, according to the L.A. County Department of Public Health. Symptoms include a fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes or feeling extra tired.

So far, every child known to have MIS-C in L.A. County was hospitalized, more than half of them ending up intensive care units.

Of the L.A. County’s children with MIS-C, 38% were between the ages of 5 and 11 years old, 35% were between the ages of 12 and 20 years old and 27% were younger than 5.

Latino children account for 73% of all cases of MIS-C in L.A. County, mirroring trends seen nationwide, according to data from the Centers for Disease Control and Prevention.

The CDC says it’s still learning about the syndrome, and it’s unclear why some children are sickened and others aren’t.

Most of the children developed MIS-C around two to four weeks after being infected with the coronavirus.

Across California, at least 152 cases of MIS-C have been reported, according to the California Department of Public Health.

Nationwide, there have been a total of 1,288 cases and 23 deaths associated with MIS-C.

California, Texas, Louisiana, Florida, Georgia, New York and New Jersey have reported the most cases of the inflammatory condition in the country so far.

L.A. County residents who believe their children are displaying MIS-C symptoms should contact their primary care providers. Those who do not have a primary care provider can call 2-1-1 to be connected with one.