What is Kawasaki disease?
Kawasaki disease is a serious and perplexing disease, the cause of which is unknown. Some researchers believe, however, that it is caused by a virus or bacteria.
Signs and symptoms
Signs of this disease include fever, usually quite high, that lasts for at least five days and doesn’t respond to antibiotics. Fever should be present to consider the disease in the acutely ill child.
In addition, four of the six following signs are present in the typical case:
Rash over some or all of the body, often more severe in the diaper area, especially in infants under six months of age.
- Redness and swelling of the palms and soles and/or cracking of the skin around the base of the nails.
- Red, swollen, and cracked lips and/or a strawberry tongue.
- Red, inflamed eyes, especially the sclerae (white part).
- A swollen gland, particularly on one side of the neck.
- Irritability or listlessness. Children with Kawasaki disease are usually crankier or more lethargic than usual. They also may complain of abdominal pain, headache, and/or joint pain.
Kawasaki disease causes inflammation of the blood vessels; in some cases this includes the arteries of the heart (the coronary arteries). This inflammation weakens the walls of the blood vessels. In most cases the blood vessels return to normal after several months, but in some cases they remain weakened and may even balloon out, causing aneurysms (blood-filled swellings of the blood vessels).
Who gets Kawasaki Disease
Kawasaki disease occurs most frequently in Japan and Korea and in individuals of Japanese and Korean ancestry, but it can be found among all racial groups and on every continent. The exact number of cases are not known, but it is probably between 5,000 and 10,000 per year in the U.S., typically among older infants and preschoolers.
Kawasaki disease does not appear to be contagious. It is extremely uncommon for two children in the same household to get the disease. Likewise, it does not spread among children in child care centers, where there is daily close contact.
Although Kawasaki disease can occur in community outbreaks, particularly in the winter and early spring, no one knows the cause. The peak age of occurrence in the United States is between six months and five years. Evidence suggests that Kawasaki disease may be linked to a yet-to-be identified infectious agent, such as a virus or bacteria. However, despite intense research, no bacteria, virus, or toxin has been identified as a cause of the disease. No specific test makes the diagnosis. The diagnosis is established by fulfilling the signs of illness mentioned above and by excluding other possible diseases.
Because the cause of Kawasaki disease is unknown, it can be treated but not prevented. If it is diagnosed early enough, intravenous gamma globulin (a mixture of human antibodies) can minimize the risk of a child developing aneurysms. In addition to gamma globulin, the child should receive aspirin, initially in high doses. Aspirin can decrease the tendency of blood to clot in damaged blood vessels. Although it’s appropriate to use aspirin to treat Kawasaki disease, treating children with minor illnesses (i.e., a cold or influenza) with aspirin has been linked with a serious disease called Reye syndrome. Always consult your pediatrician before giving aspirin to your child.