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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.
Symptoms of Kawasaki Disease
Kawasaki disease produces a fever, usually quite high, that lasts for at least five days and doesn't respond to antibiotics. This sign should be present to consider the disease in the acutely ill child.
In addition, four of the five 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 6 months of age
· Redness and swelling of the palms and soles, and/or cracking of the skin around the base of the nails
· 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 more cranky or more lethargic than usual. They 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).
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. In the United States, there are more than 3,000 reported cases a year, 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 6 months to 5 years. There is evidence to suggest 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 and by excluding other possible diseases.
Treatment of Kawasaki Disease
Because the cause of Kawasaki disease is unknown, it can be treated but not prevented. If it is diagnosed early enough, large doses of 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, then, after the fever is gone, in lower 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, use of aspirin by children to treat minor illnesses (such as a cold or influenza) has been linked with a serious disease called Reye syndrome. Always consult your pediatrician before giving aspirin to your child.