Kawasaki disease is a childhood febrile disease that leads to vasculitis (inflammation of vessels) of medium sized blood vessels. However, it can lead to inflammation of other vessels too, large vessels, veins, small arterioles and capillaries. It is the leading cause of acquired heart disease surpassing rheumatic fever in the United States now. About 85-90% children those who are affected by it are below the age of 5 years and 90-95% children are below the age of 10 years, making it a disease of childhood. Adults in their 20s or 30s are rarely affected by the disease.
How Did My Child Get Kawasaki Disease?
Why the disease affects a child is still unknown and how a child gets the disease is still speculative. There are hypotheses related to it being an infectious condition, but the disease like other infections is not contagious and a child does not get Kawasaki disease from other children suffering from it or does not spread the disease to family members when affected by it. The rate of the disease also increases in winters and springs, so children have greater chances of having the disease during these seasons. Although, many infectious agents, such as viruses and bacteria have been implicated in the disease etiology and progression, none have been confirmed till date.
Children born in Asian subcontinent, especially Japan, South Korea and Taiwan are at a greater risk of developing the disease as many studies have pointed out. Children of Japan are at 10 times greater risk of developing the disease when compared to American children. In Japan, children contract disease earlier, i.e., between 6-12 months; however, in America, children contract the disease when they are about 18-24 months old. In addition, being a male child predisposes him to contracting the disease more often than a girl child, the male to female ratio being 1.3-1.8:1 depending on different geographic area.
In addition, genetics have also been suspected for a very long time in predisposing a child to contract Kawasaki disease. Siblings of a child suffering from Kawasaki disease have a 10-20 times greater chances of developing the disease than the general population. There is also a greater chance of developing Kawasaki disease in children born to parents who suffered from the disease and in these children the chances of severity and recurrence is greater. The highest probability is in twins and the chances increases to 13%.
In addition, the chances of developing Kawasaki disease is among the Japanese children and the lowest chances of developing Kawasaki disease is for Caucasian children. Younger children younger than 12 months are at a greater chance of developing Kawasaki disease.
Although, it is not under parents control to prevent the disease, because there is no exact cause of the disease and what little data suggests regarding the etiology of the disease regarding interplay between genetical and infectious factors, no one can do anything about it as these factors can’t be controlled and not in one’s hand.
What one can do is be vigilant in the care of their child. If your child is suffering from uncompromising fever that does not go away despite treatment with paracetamol and persists for longer than 5 days, one should immediately see a doctor without delaying any further. Diagnosis at the right time and treatment before the condition worsens and progresses will prevent the disease from taking undue hazardous course in the development of cardiac complications, such as coronary artery aneurysm, myocardial infarction and sudden death.
The treatment with IVIG reduces the risk of developing cardiac complications to 3-5% as compared to 25% in untreated cases. So, where every 1 in 4 untreated child could have been affected, after treatment this risk is brought down to 1 in every 25 children. Therefore, if a child has prolonged fever along with other features, of irritability, diffuse rash, oropharyngeal changes, extremity changes, cervical lymphadenopathy and bulbar conjunctivitis, Kawasaki disease should be suspected and further investigations and treatment should be started.