An editorial commentary urged clinicians to have a high level of diagnostic suspicion and follow  WHO and CDC definitions to facilitate timely identification and treatment of cases.During July, suspected cases were being flagged and reported in Mumbai, in Delhi, Chennai, and elsewhere. In Pakistan, at least 24 children were said to have Kawasaki-like symptoms in Lahore, where 8 cases fulfilling WHO criteria were prospectively identified by 30 June. In Kazakhstan, 14 cases were confirmed by 20 August (among 2,357 children known to have been infected). Cases have been recorded in Israel, including one of a child who presented with severe central nervous system involvement and complement deficiency. In Turkey, four children with a Kawasaki-like disease probably associated with COVID-19 are reported to have been admitted to the childrens hospital of Hacettepe University in Ankara between 13 April and 11 July. In Algeria, a first case was recorded in June. In Egypt, on 10 July the authorities denied rumours of the existence of cases of Kawasaki-like disease in the country. In South Africa, the first 23 affected children were treated in Cape Town – the initial epicentre of the national COVID-19 epidemic – between 4 June and 24 July. In Ecuador, the Ministry of Health announced on 19 July the presence of 46 probable cases.
Oral and Pharyngeal Range-of-Motion Exercises
Resistance Exercises
Bolus Control Exercises
Swallowing Maneuvers
Supraglottic swallow
Super-supraglottic swallow
Effortful swallow
Mendelsohn maneuverPatients may need a combination of treatment procedures to maintain a safe and nutritionally adequate swallow. For example, postural strategies may be combined with swallowing maneuvers to allow the patient to swallow in a safe and efficient manner. The most common interventions used for those with oropharyngeal dysphagia by speech language pathologists are texture modification of foods, thickening fluids and positioning changes during swallowing. The effectiveness of modifying food and fluid in preventing aspiration pneumonia has been questioned and these can be associated with poorer nutrition, hydration and quality of life. Also, there has been considerable variability in national approaches to describing different degrees of thickened fluids and food textures. However, in 2015, the International Dysphagia Diet Standardisation Initiative (IDDSI) group produced an agreed IDDSI framework consisting of a continuum of 8 levels (0-7), where drinks are measured from Levels 0 – 4, while foods are measured from Levels 3 – 7. It is likely that this initiative, which has widespread support among dysphagia practitioners, will improve communication with carers and will lead to greater standardisation of modified diets

Epidemiology
Swallowing disorders can occur in all age groups, resulting from congenital abnormalities, structural damage, and/or medical conditions. Swallowing problems are a common complaint among older individuals, and the incidence of dysphagia is higher in the elderly, and in patients who have had strokes. Dysphagia affects about 3% of the population.