Since coming down with Covid-19 in September (2021), 11-year-old Malisse Kafi has found it difficult to eat or drink because everything tastes “like poo and rotten eggs”.
His mum Dawn Kafi, from Liverpool, England, said: “It began with Malisse thinking his food had gone off.
“He says that food tastes like poo and sewerage, and water tastes of rotten eggs.
“He just stopped eating – food was making him retch and gag. It was horrendous.
“It was really hard to know what to do.
“We tried everything to try and get him to eat, cooking all his favourite foods, but it all just made him feel really sick.”
Malisse was diagnosed with parosmia – a symptom where people experience strange and often unpleasant smell distortions – and given a steroid nasal spray, but it didn’t help.
By November, he had lost around 2kg and was rushed to hospital, dehydrated and slurring his words.
“We had never heard of parosmia before.
“It has been absolutely heartbreaking to see him deteriorate,” said Dawn.
Eventually, Malisse needed to be fed via a nasogastric tube.
Now, his parosmia is still a problem, but it is beginning to improve and he has some “safe” foods that he can eat.
Dawn said: “Things are improving slowly, but he is still extremely tired and cold all the time, and he is very pale.
“He’s still very skinny and he has lost a lot of muscle.
“It has caused him a lot of ill health, including ongoing bowel issues and pains in his legs.”
More and more children could be turning into such “fussy eaters” after a bout of Covid-19, according to smell experts at the University of East Anglia (UEA), United Kingdom, and Fifth Sense, the UK charity for people affected by smell and taste disorders.
Like Malisse, it is likely because they are suffering from parosmia.
Smell expert and UEA Norwich Medical School professor Dr Carl Philpott said: ”Parosmia is thought to be a product of having less smell receptors working, which leads to only being able to pick up some of the components of a smell mixture.
“We know that an estimated 250,000 adults in the UK have suffered parosmia as a result of a Covid-19 infection.
“But in the last few months, particularly since Covid-19 started sweeping through classrooms last September, we’ve become more and more aware that it’s affecting children too.
“In many cases, the condition is putting children off their food, and many may be finding it difficult to eat at all.
“It’s something that until now hasn’t really been recognised by medical professionals, who just think the kids are being difficult eaters without realising the underlying problem.”
In fact, Prof Philpott himself is seeing teenage patients with parosmia for the first time in his career.
“For some children – and particularly those who already had issues with food, or with other conditions such as autism – it can be really difficult.
“I expect there are a lot of parents at their wits’ end and really worried,” he added.
Fifth Sense chair and founder Duncan Boak said: “We’ve heard from some parents whose children are suffering nutritional problems and have lost weight, but doctors have put this down to just fussy eating.
“We’re really keen to share more information on this issue with the healthcare profession so they’re aware that there is a wider problem here.”
Together with Prof Philpott, Fifth Sense have put together guidance for parents and healthcare professionals to help them better recognise and understand the condition.
First and foremost, the guidance indicates that children should be listened to and believed.
Parents can help by keeping a diary to make a note of foods that are safe and those that are triggers.
Prof Philpott said: “Establishing what the triggers are and what tastes OK is really important.
“There are lots of common triggers, e.g. cooking meat and onions or garlic, and the smell of fresh coffee brewing, but these can vary from child to child.
“Parents and healthcare professionals should encourage children to try different foods with less strong flavours such as pasta, bananas or mild cheese, to see what they can cope with or enjoy.
“Vanilla or flavour-free protein and vitamin milkshakes can help children get the nutrients they need without the taste.
“And it may sound obvious, but children could use a soft nose clip or hold their nose while eating to help them block out the flavours.”
Finally, children and adults alike should consider “smell training”.
Prof Philpott said: “Smell training involves sniffing at least four different odours twice a day every day for several months.
“Children should use smells that they are familiar with and are not parosmia triggers.
“In younger children, this might not be helpful, but in teenagers, this might be something they can tolerate.”