What is Kawasaki Disease?
Kawasaki Disease is an unusual illness characterized by inflammation of blood vessels throughout the body. It is accompanied by the following symptoms:
- Fever
- Rash
- Swelling of the hands and feet
- Irritation and reddening of the eyes
- Irritation and inflammation of the mucous membranes of the mouth, lips, and throat
- Swollen lymph nodes in the neck
The immediate effects of Kawasaki Disease may not be serious but, in some cases, long-term complications including damage to the coronary arteries may result.
Kawasaki Disease affects children almost exclusively; most patients are under 5 years of age. For reasons still unknown, males acquire the illness almost twice as often as females.
The disease is named after a Japanese pediatrician who described this particular pattern of signs and symptoms in 1967. Since then, Kawasaki Disease has been found to occur most frequently among Japanese children. In the United States, the disease has been reported in all racial and ethnic groups but occurs most often among children of Asian-American background. Kawasaki Disease is not a rare illness, it can occur in clusters or localized outbreaks usually in the winter and spring.
How often do you see Kawasaki Disease (KD)?
The disease is more common than you think. For instance;
- Tuberculosis affects approximately 4 in 100,000 children.
- Kawasaki’s Disease affected 70 children in San Diego County in 2008, at a rate of 25 cases per 100,000 children under 5. Yet most parents have never heard of it or do not know what it is.
- Since January 1, 2009 we have seen 16 new cases of KD in San Diego County, clustering in the North County area.
Did Kawasaki Disease have anything to do with John Travolta’s son’s tragic death??
NO! Absolutely not!! He died as a result of his seizure disorder and this was in no way related to his history of having Kawasaki Disease as a young child.
What causes Kawasaki Disease?
To date, no cause of Kawasaki Disease has been identified. Most experts agree that an infectious cause (such as a virus or bacteria) is likely, although a hereditary tendency may also exist and could explain why the disease occurs more frequently among persons of Japanese ancestry. At the present time there is no evidence that the disease is contagious.
What are the signs and symptoms?
- Fever and irritability often occur first. The fever has a rapid onset and fluctuates from moderate (101 to 104 F) to high (above 104).
- Lymph nodes in the neck may become swollen.
- A rash usually appears early in the illness; some patients may develop an accentuated rash in the groin. Often vivid red in appearance. The rash is composed of either poorly defined spots of various sizes or larger masses of merging spots.
- Fever continues to rise and fall, possibly for up to three weeks.
- Eye inflammation (conjunctivitis), usually without discharge, develops during the first week of illness.
- A child’s tongue may be red and show small, raised bumps (papillae); a condition called “strawberry tongue” because the enlarged papillae resemble the seeds on a strawberry’s surface.
- The lips become dry and cracked and often take on a bright red color. Mucus membranes of the mouth turn a darker red than usual.
- The palms of the hands and soles of the feet often turn bright red. Hands and feet can swell.
- Occasionally, a child may develop a stiff neck. The child usually has great difficulty getting comfortable and remains irritable as a result of the multiple signs and symptoms.
When the fever subsides, the rash, red eyes and the swollen lymph nodes usually disappear. Skin starts to peel around the toenails and fingernails, often beginning during the third week of illness. The skin on a hand or foot may peel off in large pieces or even a single piece (much as a snake sheds its skin). Knees, hips and ankles can become more inflamed and painful.
How does a doctor determine if a child has Kawasaki Disease?
A physician makes a diagnosis of Kawasaki Disease after carefully examining a child, observing signs and symptoms, and after ruling out the possibility of other diseases that can cause similar problems.
- Blood tests are used to detect mild anemia, a white-blood-cell count above normal and an elevated erythrocyte sedimentation rate which indicates blood vessel inflammation. A sharp rise in the number of platelets, the major clotting element in the blood, may also be detected.
- Urine tests may reveal unusual white blood cells in the urine.
- Irregular heart rhythms (arrhythmias) and evidence of heart muscle strain, indicating involvement of the heart, can be detected by an electrocardiogram (EKG). Echocardiography (a sound wave diagnostic test of heart and blood vessel structure and function) is necessary to evaluate possible damage to the heart or large blood vessels.
How is Kawasaki Disease treated?
- A high dose of gamma globulin (a protein fraction of human blood) administered intravenously is the treatment of choice for patients with Kawasaki Disease. This treatment is most effective in reducing inflammation and preventing coronary artery damage if it is started within the first 10 days of illness.
- High doses of aspirin are also given with gamma globulin during the acute phase of the illness until the fever subsides.
- If diagnostic tests reveal the presence of an aneurysm (dilated segment of the coronary artery) or any other heart or blood vessel abnormality, medical or surgical treatment may be needed. Your doctor may recommend that a cardiologist monitor a heart or blood vessel problem for several years following recovery from Kawasaki Disease.
Can Kawasaki Disease be prevented?
Unfortunately, at this time, Kawasaki Disease cannot be prevented. However, programs such as the Kawasaki Disease Research Program in San Diego (the only KD research center in the world) are working in conjunction with researchers throughout the United States and Japan to further understand this mysterious disease.
Links to other helpful information on Kawasaki Disease:
