Epidemiologic picture of Kawasaki disease in Korea, 2000–2002

BACKGROUND: The aim of this study was to investigate the incidence rate and epidemiologic patterns of Kawasaki disease in Korea for a 3 year period during 2000 to 2002. METHODS: An epidemiologic survey on Kawasaki disease was retrospectively performed. The questionnaire was sent to all 112 hospitals having pediatric residency programs, and obtained data were analyzed. RESULTS: The 9150 cases of Kawasaki disease from 92 hospitals which responded (response rate, 82.1%) included 5515 males and 3635 females (male : female ratio, 1.52:1). The incidence rate per 100,000 children <5 years old was 73.7 in 2000, and increased to 90.8 in 2001, and 95.5 in 2002 (average rate, 86.4). The monthly number of patients was slightly higher in May, June and July. Their mean age of onset, the proportion of sibling cases, and a rate of recurrent cases were 30.5 months, 0.17%, and 2.9%, respectively. Coronary arterial abnormalities occurred in 18.6% of cases including dilatations of 17.3% and aneurysms of 3.1%. CONCLUSION: The average annual incidence, 86.4/100 000 in children <5 years old is the second highest rate in the world.     

Kawasaki disease in Korea, 2003-2005

PURPOSE: The aim of this study was to investigate the incidence rate and epidemiologic patterns of Kawasaki disease in Korea for the 3-year-period, 2003-2005. METHODS: The questionnaire for an epidemiologic survey on Kawasaki disease was distributed to all 102 Korean hospitals that conduct pediatric residency programs, and obtained data were analyzed upon receipt. RESULTS: The 9662 patients of Kawasaki disease from 85 hospitals that responded (response rate, 83.3%) consisted of 5877 males and 3785 females (male:female ratio, 1.55:1). The incidence rate per 100,000 children <5-year-old was 104.2 in 2003, 106.4 in 2004, and 104.6 in 2005 (average rate, 105.0). Their mean age of onset was 33.3 months, and the proportions of sibling cases and recurrent cases were 0.29% and 2.0%, respectively. Coronary arterial abnormalities were detected at follow-up by echocardiogram in 18.8% of all such cases including dilatations of 18.0% and aneurysms of 2.5%. CONCLUSION: The average annual rate of incidence, 105.0/100,000 in children <5-year-old is the second highest reported rate in the world.     

Repeated systematic surveillance of Kawasaki disease in Ontario from 1995 to 2006

Background: Rising incidences of Kawasaki disease (KD) have been reported worldwide. Reported herein are the results of 4 triennial KD surveillances conducted in Ontario. Methods: Between 1995 and 2006 all hospitals in Ontario were asked on 4 occasions to identify all patients with discharge diagnoses of KD and report incident cases. Results: The latest surveillance identified 697 new KD patients (100% response rate) for a total of 2378 KD patients through all 4 surveillances. Yearly incidence was 26.2/100 000 for <5 years old, 6.7/100 000 for 5–9 years old and 0.9/100 000 for 10–14 years old. KD incidence significantly increased from 1995 to 2006, although the increase seemed to plateau between the 3rd and 4th surveillance. There was an increase in the proportion of patients diagnosed with incomplete KD and a significant reduction in the rate of coronary artery abnormalities, possibly due to better disease recognition and treatment. Hospitals reporting <20 cases per surveillance were found to be more likely to report cases with incomplete KD. These patients were also less likely to be treated with i.v. immunoglobulin and aspirin but were more likely to be treated with antibiotics, suggesting uncertainties regarding diagnosis and management of KD patients in those centers. Conclusions: The incidence of KD in Ontario is possibly one of the highest outside of Asia and has been rising since 1995. Although the most recent surveillance demonstrated improved cardiac outcomes, treatment delays or absence thereof continue to be a problem. Effective diagnosis and prompt treatment remain critical aspects of KD management.     

1997～2001年四川省川崎病流行病学调查

目的了解四川省川崎病(KD)的发病率和流行病学特点。方法按日本川崎病研究中心提供的川崎病诊断标准、问卷表格和调查方法,对四川省内设有儿科病床的医院进行问卷调查。收集1997年1月1日～2001 年12月31日的川崎病患儿住院资料。结果调查全省212所医院,调查表回收率达到91．5％,全省共报告了KD 患儿1811例,符合川崎病诊断标准1511例。1997～2001年<5岁儿童患病率分别为4．26／10万、5．21／10万、8．57／ 10万、7．70／10万、9．81／10万,5年平均发病率为7．06％。男女之比为1．66:1,发病高峰为1～2岁,17．0％的川崎病患儿有心脏冠脉损伤。典型病例占94．6％,使用静脉丙种球蛋白(IVIG)治疗者占70．9％。结论 1997～2001年四川省5年川崎病的发病率低于日本,与国内其他地区KD流行病学资料相比,发病率高于江苏、陕西和广东,低于北京,有逐年增高趋势。     

云南省1997-2006年儿童川崎病临床流行病学调查研究

目的对云南省近10a儿童川崎病(KD)发病情况进行流行病学调查,分析云南省川崎病发病、分布、流行特征及临床预后。方法采用日本-中国KD流行病学调查表对云南省136家设有儿科的县级以上医院,于1997年1月1日-2006年12月31日10a间住院的川崎病患儿进行填表调查。每5年进行1次,共进行2次。结果反馈调查信息共130家,调查表回收率95.6%,15个地区47家医院共报告KD患儿1662例;云南省儿童KD发病率1997年为0.351/万,而2006年达1.36/万,平均0.651/万;男女比为1.58:1.0;发病年龄2个月～14岁,5岁以下患儿占74.19%;患儿多集中于城市,但农村患儿有增加趋势;共11个少数民族,其患儿占6.4%;全年均可发病,无明显高峰季节;临床症状以发热5d以上最为常见;急性期冠状动脉改变为20.64%,其中冠状动脉扩张占冠状动脉改变的82.5%,冠状动脉瘤占17.5%,急性期无死亡病例,再发率为0.36%。结论云南省KD发病率呈增高趋势;在省内有明显的区域分布,高寒地区无病例报道;发病年龄5岁以下儿童居多,性别分布和冠状动脉损害与国内部分省市相近;KD冠状动脉病变已是儿童后天性心脏病的主要病因之一,急性期早期诊断治疗是避免发生后遗症的重要措施。     

Incidence of Kawasaki disease in Japan: the nationwide surveys of 1999–2002

BACKGROUND: The purpose of the present study was to describe the results of nationwide epidemiologic surveys of Kawasaki disease for the 4 year period 1999-2002. METHODS: The design is a retrospective incidence survey. The patients reported in these two surveys are all new patients who were reported during the two study periods (1999-2000 and 2001-2002), although the data were collected retrospectively. A questionnaire was sent to all pediatric departments of hospitals with 100 beds or more throughout Japan, requesting data on patients with Kawasaki disease, such as sex, age, date of first hospital visit, recurrence, and cardiac lesions. RESULTS: The total number of patients reported in the 4 year period 1999-2002 was 32 266 (18 604 male, 13 662 female), with an average annual incidence of 137.7 per 100 000 children younger than 5 years old. The male/female ratio was 1.30. The incidence peaked at 9-11 months of age, and the proportion of patients under 1 year of age was 26%. The monthly distribution had a high peak in January and a gradual increase in summer. Geographically, the high-incidence areas were limited to certain prefectures and moved from year to year. The cardiac lesions at acute stage and cardiac sequelae occurred more in children under 1 year and older than 4 years. Among the principal symptoms, fever persisting >or=5 days occurred most commonly, followed by conjunctival congestion, changes in lips and oral cavity, polymorphous exanthema, and changes of extremities. Cervical lymphadenopathy occurred less. CONCLUSION: More than 32 000 patients with Kawasaki disease during the 4 year period 1999-2002 were reported to the nationwide incidence surveys. The number of patients is steadily increasing despite the decrease of children. The seasonal variation, geographical distribution, and age-specific distribution support the infection theory for the etiology of Kawasaki disease.     

Incidence of Kawasaki disease in northern European countries

Background: The aim of the present study was to compare the epidemiologic features of Kawasaki disease (KD) in three northern European countries and Japan. Methods: Data were obtained from discharge databases for hospitals in Finland, Norway, and Sweden for 1999–2009 and from nationwide epidemiologic surveys in Japan for 1998–2008. Annual incidence for each country was calculated using regional census data. Results: During the 11 year period, 1390 KD patients were recorded in the registries of the three northern European countries. Average annual incidence rates per 100 000 children aged <5 years were: Finland, 11.4; Norway, 5.4; and Sweden, 7.4. Overall, 86.4% of Japanese KD patients were aged <5 years compared to only 67.8% in the four northern European countries (P < 0.001). Conclusions: The incidence of KD in northern Europe was constant over the study period and much lower than in Japan. There was a significant age difference between northern European and Japanese KD patients that remains unexplained.     

上海地区1998－2002年川崎病流行病学特征

目的 对上海地区川崎病发病情况进行调查，了解中国发达地区川崎病的流行病学特征。方法 参照日本流行病学调查方案，制作统一调查表和诊断指南，调查对象为1998年1月1日－2002年12月31日上海地区50家有儿科临床服务的二级及二级以上医院收治的所有川崎病病例。结果 调查表回收率100％，将18例不符合表格填写要求者剔除后，对768例进行分析。上海地区5岁以下儿童川崎病发病率呈逐年增高趋势， 1998年为16.79/10万，1999年为25.65/10万，2000年为28.16/10万，2001年为28.05/10万，2002年为36.76/10万。男女性别比为1.83:1；发病年龄为1个月～18.8岁（中位数1.8岁），发病年龄高峰为9.6个月；全年均可发病，但以春夏之交较多见。主要症状表现为发热持续5 d以上者最为常见（99.3％），其后依次为口唇、口腔黏膜损害（83.5％）、指（趾）端脱皮（82.9％）、皮疹（81.0％）、结膜充血（78.4％）、颈部淋巴结肿大（69.3％）、肢端充血硬肿（48.1％），45.2％的病例有肛周脱皮。心血管损害发生率24.3％，以冠状动脉扩张最为常见，占68％，其次为冠状动脉瘤，占10%。急性期病死率为0.26%，死因为冠状动脉瘤破裂和急性心力衰竭。再发率为1.82%。 结论 上海地区川崎病发病率明显低于日本，但高于西方国家。发病率呈增高趋势，性别分布和心血管损害与其他报道相似。发病季节分布与北京地区的报道相似，但与其他报道不同。     

Increasing incidence of Kawasaki disease in Japan: Nationwide survey

Background: The last nationwide survey of Kawasaki disease in Japan was conducted in 2003; the epidemiologic features of the disease in Japan since then are unknown.
Methods: All the hospitals with a pediatric department and a bed capacity of ≥100, or hospitals having a bed capacity of <100 but specializing in pediatrics in Japan were asked to report (by mail) all patients with Kawasaki disease who visited the hospital due to the disease in 2003 and 2004.
Results: Of the 2335 hospitals asked to participate, 1058 reported 19 138 patients with Kawasaki disease during the 2 year period 2003–2004. The annual incidence in 2004 reached 174.0 per 100 000 children under 5 years of age. The yearly number of patients and annual incidence increased significantly after the last nationwide epidemic of the disease in 1986. The number of patients was largest in January and lowest in October. The age-specific incidence was highest for those aged 9–11 months, and 88.9% of the patients were under 5 years of age. Of the reported patients, 2595 (13.6%) had cardiac lesions in the acute phase of the disease and 844 (4.4%) had cardiac sequelae 1 month after the onset of the disease.
Conclusion: The number of patients and the incidence of Kawasaki disease in Japan has increased year by year in the last two decades.     

Epidemiologic characteristics of children hospitalized for Kawasaki disease in California

OBJECTIVE: To evaluate the epidemiologic pattern of Kawasaki disease (KD) in California. METHODS: Statewide hospital discharge data from California from 1995 through 1999 were used. Children 0 through 17 years old who had a discharge diagnosis of KD (by ICD9-CM code 446.1) were identified. Precipitation and temperature data of climate divisions of the state were used to determine their possible association with incidences of KD. Multiple regression analysis was performed to evaluate factors related to the KD incidence of the counties. RESULTS: There were 2,325 patients admitted to 194 California hospitals during the 5-year study period. The male-to-female ratio was 1.62. Median age was 30 months; peak incidence by year of age was in the second year of life. Overall annual incidence was 15.3 cases per 100,000 children <5 years old and 3.2 cases per 100,000 children 5 through 9 years old. Compared with 1995 and 1996, the incidence for children <5 years old increased by 30% in 1997 and 1998 (P < 0.01). In contrast the incidence for children 5 through 9 years old remained relatively unchanged. Asians had the highest incidence of 35.3 cases per 100,000 children <5 years old, followed by blacks (24.6) and whites (14.7) (P < 0.01). The number of cases peaked in March and had its nadir in September. In a multiple regression analysis, no association was found between KD incidence and temperature or precipitation. KD incidence was not related to average family size, proportion of Asians in the population, population density or whether the county is in northern or southern California. There was no in hospital death. The median length of hospital stay was 2 days. CONCLUSIONS: The incidence of Kawasaki disease in patients <5 years old increased in 1997 and 1998. Asians had the highest KD incidence compared with other races. Peak incidence was in March, and the lowest incidence was in September. KD incidence was not associated with temperature, precipitation, family size or population density.     

Rebound in the incidence of pneumococcal meningitis in northern France: effect of serotype replacement

Aim: To determine whether the recent emergence of nonvaccine pneumococcal serotypes has affected the incidence of pneumococcal meningitis in children a few years after the introduction of the heptavalent pneumococcal conjugate vaccine. Methods: We conducted a multicentre retrospective cohort study from 2005 to 2008 in all hospitals with paediatric units in northern France. It included all patients <18 years of age who were admitted for laboratory‐confirmed pneumococcal meningitis during the study period. Data were collected from medical files and laboratory records at each hospital and compared with the regional hospital discharge codes. We assessed global and age‐specific incidence rates of pneumococcal meningitis from 2005 through 2008, compared them with those from the prevaccine era (2000–2002) and evaluated pneumococcal serotypes. Results: In all, 41 cases were found during the study period. The incidence rate of pneumococcal meningitis varied from 0.8/100 000 children <18 years in 2005 to 1.8/100 000 children in 2008 (2.2‐fold increase, p = 0.06); and from 1.8 to 11.9/100 000 children <2 years (6.5‐fold increase, p = 0.004). This increase was caused by nonvaccine pneumococcal serotypes. Conclusion: The incidence of pneumococcal meningitis in infants has rebounded in northern France during the pneumococcal conjugate vaccine programme, with the emergence of nonvaccine pneumococcal serotypes.     

Risk of coronary abnormalities due to Kawasaki disease in urban area with small Asian population

The epidemiology of Kawasaki disease in the six-county Chicago metropolitan area (total population, greater than 7,100,000 inhabitants) was characterized by identifying cases, with onset occurring from 1979 to 1983, inclusively, that had been studied by echocardiography. A retrospective survey of the records from pediatric echocardiographic laboratories and pediatric cardiologists at teaching hospitals, as well as a random sample survey of nonteaching hospitals with pediatric beds in the metropolitan area, was carried out. A total of 190 cases were identified, yielding an annual mean minimum incidence of 5.95 per 100,000 children less than 5 years old. Cases occurred endemically with superimposed spring clusters in 1980 and 1983. As seen in other studies, the male-female ratio was 1.58:1, and the peak incidence occurred in children between 1 and 2 years old, with 85% of cases occurring in children under 5 years of age. The racial distribution of cases was as follows: whites, including Hispanics, 62%; blacks, 32%; Asians, 5%; and half-white/half-Asian, 1%. Asians were slightly overrepresented in that they made up only 1.7% of the study area population. The annual minimum incidence for Asian Americans was 24.4 per 100,000 children less than 5 years old; this rate was significantly greater than those for the other racial groups. Although few cases were observed in Japanese-American children, the calculated annual minimum incidence in this small group was approximately 44 per 100,000 children less than 5 years old. The highest incidence was observed in several suburban Chicago zip code areas, where annual rates as high as 84.7 per 100,000 children less than 5 years old were documented. Coronary artery abnormalities were diagnosed by echocardiography in 30 (16%) of 190 cases; the male-female ratio of patients with such abnormalities was 2.75:1. Whites and children under 1 year of age demonstrated the highest incidence of coronary artery abnormalities. White children under 1 year of age appeared to be at particularly high risk for development of coronary abnormalities, with 11 (41%) of 27 white infants manifesting such findings by echocardiography. These infants may represent a subgroup of patients who would benefit particularly from therapy with intravenous gamma globulin for prevention of coronary abnormalities and who require particularly close follow-up care.     

Kawasaki disease in Sweden: incidence and clinical features

The incidence and clinical pattern of patients with Kawasaki disease in Sweden and the outcome of treatment with iv immunoglobulin (Sandoglobulin) and aspirin were examined in a national prospective study over a 2-year period. Cases not referred to the study were identified by inquiry. Ninety-nine children were diagnosed as having Kawasaki disease. The annual incidence rate was calculated to be 2.9per 100 000 in children younger than 16 years of age and 6.2 per 100000 in children younger than 5 years of age. The median age of our patients was 2.2 years and the male-to-female ratio was 2.3:1. Cardiac ultrasonography revealed abnormalities in 33% of all patients, and 14% of cases in the prospective study had pronounced abnormalities. In most cases (91%) treatment had a prompt effect on fever and morbidity in general, and side effects were mild. Two infants, identified from the inquiry, died from rupture of an aneurysm in the coronary artery in the acute phase of the disease. The risk of cardiac involvement is obvious and emphasizes the importance of early diagnosis and treatment. Incidence, Kawasaki disease, vasculitis     

Epidemiological survey of Kawasaki disease in Sichuan province of China

OBJECTIVES: To investigate the incidence and epidemiological characteristics of Kawasaki Disease (KD) in Sichuan province of China. METHODS: The questionnaire and diagnostic guideline for KD provided by Japan Kawasaki Disease Research Center (JKDRC) were used for the questionnaire investigation in pediatric departments of all hospitals in Sichuan province for data of KD diagnosed in their hospitals from 1 January 1997 to 31 December 2001. RESULTS: Of the 212 hospitals investigated, 91.5% responded to the questionnaire investigation, with a total of 1811 cases of KD identified. The incidence per 100,000 children <5 years of age was 4.26 in 1997, 5.21 in 1998, 8.57 in 1999, 7.70 in 2000 and 9.81 in 2001, respectively. The average incidence throughout the 5 years was 7.06 per 100 000. The ratio of male to female was 1.62 : 1. The age distribution showed a peak near 1-2 years of age. Cardiac sequelae were seen in 17.0% of the patients. Only 66.2% patients with KD had been treated with intravenous immunoglobulin. CONCLUSION: The incidence of KD in Sichuan province was lower than that reported in Japan and Beijing, higher than that in Guangdong, Jiangsu and Shanxi province of China.     

Current status and clinical presentations of invasive neonatal Group B streptococcal infections in Korea

Background: Group B streptococcus (GBS) is the most common cause of invasive neonatal infections in developed countries. The incidence of early‐onset GBS disease in Korea is known to be much lower than that in other developed countries; however neonatal GBS disease has been frequently reported in recent years in Korea. This retrospective study sought to determine the current status and clinical presentation of neonatal GBS disease in Korea. Methods: From January 1996 through December 2005, GBS cases (n= 157) diagnosed in blood, cerebrospinal fluid, or other sterile body fluids among infants <3 months of age from 14 university hospitals in Korea were identified. Age of onset, diagnosis, underlying medical conditions, and outcomes were investigated by reviewing the medical records. Results: A total of 157 cases were identified during the study period. Of the cases, 32 were early‐onset disease (EOD) and 125 were late‐onset disease (LOD). Twenty‐six of the EOD cases had symptoms during the first 24 h after birth. One hundred of the 157 GBS cases were diagnosed as meningitis. The mortality rate of EOD was 20.7%. The case fatality rate of LOD was 7.2% and 25.2% of LOD cases had sequelae. Conclusions: GBS is becoming an important cause of invasive neonatal infections in Korea, with LOD being more common. It may not be currently necessary to adopt the prevention guidelines of perinatal GBS disease in Korea. However, studies of maternal GBS carriage rates and neonatal GBS disease will continue.     

2002-2010年北京儿童医院川崎病住院患儿临床分析

目的总结川崎病的临床特征,以指导临床治疗。方法回顾性分析2002年1月-2010年12月1 484例北京儿童医院川崎病住院患儿临床资料,总结分析其临床特征。结果北京儿童医院川崎病患儿年龄分布为2个月～14.7岁,高峰年龄为1岁;男女=1.821,复发率1.7%。6种主要临床表现中,发热为最常见临床表现,皮疹发生率最低。1 484例川崎病患儿中行2 g.kg-1IVIG初次治疗者占92.4%,其中IVIG无反应型川崎病发生率为16.9%。实验室检查中CRP升高、ESR升高、白细胞升高、贫血、血浆清蛋白降低、低钠血症、肝功能异常、心肌酶异常发生率分别为94.5%、96.4%、89.2%、72.3%、81.8%、37.9%、56.9%、27.4%。其中贫血及心肌酶升高婴幼儿发生率较高,且除贫血和肝功能异常外,其他化验指标在冠状动脉扩张发生率方面无统计学差异。冠状动脉扩张发生率为36.1%,非冠状动脉心血管并发症中,心电图异常最常见,发生率为32.3%。结论本组90%以上的川崎病患儿CRP及ESR升高,提示CRP及ESR可作为川崎病尤其是不完全川崎病的参考诊断指标,除贫血和肝功能异常外其他化验指标在冠状动脉扩张发生率方面无统计学差异,提示这2项指标在一定程度上可反映病情的轻重。     

Meningitis in Hong Kong children, with special reference to the infrequency of haemophilus and meningococcal infection

Objective: To study the epidemiologic and aetiologic features of meningitis in children in Hong Kong.
Methodology: A retrospective study of 85 children resident in the New Territory East region of Hong Kong admitted to a teaching Hospital because of meningitis during a 9 year period.
Results: Mycobacterium tuberculosis was the most common aetiological agent accounting for 13 cases (15.3%). Other bacteria accounted for 41 cases (48%); among these one fifth were caused by Haemophilus influenzae type b. The overall admission rates for tuberculous meningitis in Chinese children were 0.76/100 000 (95% CI 0.25-1.78) and 0.42/100 000 (CI 0.19-0.8) per year, respectively, for under 5 year olds and under 15 year olds. The overall annual incidence rates of bacterial meningitis other than tuberculous were 5.2/100 000 (CI 3.72-7.43) and 1.6/100 000 (CI 1.14-2.29) for Chinese children under 5 years and under 15 years, respectively. The annual incidence of H. influenzae meningitis in Chinese children under 5 years old was low at 1.1/100 000 (0.43-2.2). All five cases of meningococcal meningitis were in Vietnamese children (under 5 years of age incidence: 13.0/100 000 per year, CI 4.2-30.3). There were no cases of meningococcal meningitis in Chinese children during the 9 year period.
Conclusion: M. tuberculosis was the most common aetiological agent of meningitis in Hong Kong children. The incidence of haemophilus or meningococcal meningitis was very low.     

Epidemiologic Survey of Kawasaki Disease in Jilin from 1999 Through 2008

The epidemiologic pictures of Kawasaki disease (KD) in Jilin Province of China is still not clear. We sent a questionnaire form and diagnostic guidelines for KD to the province's 32 hospitals above the county and city level with pediatric in-patients. All patients with KD diagnosed during January 1999 through December 2008 were recruited in this survey. The incidence of KD was 1.39 to 11.07 (5.26 ± 3.97) per 100,000 children under the age of 5 years between 1999 and 2008. The ratio of male to female was 1.96 to 1. Ages at onset ranged from 58 days to 14 years. Patients under 5 years of age accounted of 88.73%. The disease occurred throughout the year, but it occurred more frequently in May to July and November. The most common cardiac abnormality was coronary artery dilatation (49.5%). Age at onset and hypoalbuminemia (<30 g/l) were selected for multivariate logistic regression equation. In conclusion, incidences of KD increased in Jilin Province. Age and gender distribution shared similarities with previous reports, and the seasonal distribution was different. Age and lower serum albumin were the most important risk factors of coronary arterial lesions (CAL) in KD. In addition, patients treated with steroids also had a possible heightened risk of contracting CAL.     

Outbreak of Kawasaki syndrome in Finland

During a ten-month period from June 1981 to March 1982 83 patients with Kawasaki syndrome were diagnosed in Finland. The attack rate was 26/100 000 children under five years of age, corresponding to an annual attack rate of 31/100 000 children under five years. The course of the outbreak suggested geographic spreading. 20% of the patients had clinical and ECG evidence of carditis, and ECG abnormalities were found in 59% of the patients. One patient died from a ruptured coronary aneurysm. Neurologic manifestations were seen in 10% of the patients. This is the first reported outbreak of Kawasaki syndrome outside Japan, Korea and the United States of America.     

Epidemiologic study of Kawasaki disease at a single hospital in Daejeon, Korea (1987 through 2000)

PURPOSE: We evaluated the epidemiology and a range of clinical characteristics in children with Kawasaki disease (KD) in one area of South Korea. METHODS: We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from January 1987 through December 2000. RESULTS: The mean annual frequency was 36.1 +/- 11.1 cases per year. There were 55 cases (10.9%) in 1993, 50 cases (9.9%) in 1994 and 47 cases (9.3%) in 2000. There was a slightly higher occurrence in summer with no significant difference in seasonal frequency. Age distribution ranged from 2 months to 13 years of age (mean, 2.4 +/- 1.7 years) and 485 children (95.8%) were <5 years of age. The male-to-female ratio was 1.7:1. Of the total cases 0.6% was recurrent, whereas 0.4% occurred between siblings. There were no fatalities. For treatment aspirin alone (65 cases, 12.8%), divided dose intravenous immunoglobulin (IVIG) (400 to 500 mg/day for 4 to 5 days, 231 cases, 45.7%) and one dose IVIG (2.0 g/kg, 210 cases, 41.5%) were used. Between 1996 and 2000, 143 cases were treated with only one dose IVIG, and 21 cases (14.7%) showed coronary artery lesions (CAL). Among the 143 cases 22 cases (15.4%) were retreated with IVIG and/or steroid pulse therapy. The incidence of CAL in this group was 50.0%. CONCLUSION: In Daejeon, Korea, KD showed slight annual variations without seasonal differences. The rate of CAL in acute stage with one dose IVIG therapy (2 g/kg) was 8.3% in the IVIG responders.