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.     

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.     

Tick-borne encephalitis in Swiss children 2000-2004: five-year nationwide surveillance of epidemiologic characteristics and clinical course

Tick-borne encephalitis occurred in 55 children, ranging from 6 weeks to 15 years old. Average annual incidence was 1.0 per 100,000 in all children, and 0.4 per 100,000 in children less than 6 years old. Moderate to severe residua were present in 5 patients (9%) at hospital discharge and in one 9-year-old patient (1.8%) at follow-up. Permanent residua occur in children approximately 10 times less often than in adults.     

Kawasaki syndrome in Hawaii

OBJECTIVE: To describe the incidence and epidemiology of Kawasaki syndrome (KS) in Hawaii. METHODS: Retrospective analysis of the State Inpatient Database for Hawaii residents hospitalized with KS during 1996 through 2001. RESULTS: During 1996 through 2001, 267 persons younger than 18 years of age living in Hawaii were hospitalized with KS; 226 (84.6%) were younger than 5 years of age. The average annual incidence for KS was 45.2 per 100,000 children younger than 5 years of age. The incidence was higher for children younger than 1 year of age than for those 1-4 years of age (74.3 and 37.5 per 100,000). The KS incidence for Asian and Pacific Islander children and for White children was 70.9 and 35.3 per 100,000, respectively. Incidence was highest among Japanese American children living in Hawaii (197.7 per 100,000). Honolulu County had the most KS patients (85.0%) and the highest incidence (53.1 per 100,000) among Hawaii counties. For children younger than 5 years of age hospitalized with KS, the median length of stay was 2 days, and the median hospital charge was $9379. CONCLUSION: During 1996 through 2001, the annual incidence rate for KS among children younger than 5 years of age in Hawaii was the highest in the United States. The incidence among Japanese American children in Hawaii was higher than that among other racial groups in the state and when compared with children living in Japan.     

Population-based surveillance for childhood invasive pneumococcal disease in the era of conjugate vaccine

BACKGROUND: Heptavalent pneumococcal conjugate vaccine was licensed in the United States in February 2000 and, following national guidelines, universally distributed in Massachusetts starting in July 2000 to children younger than 2 years of age and selected children 2-5 years of age. We performed statewide surveillance for all cases of invasive pneumococcal disease (IPD) in children younger than 18 years of age to determine risk features and contribution of vaccine failure to ongoing pneumococcal invasive disease. METHODS: Massachusetts pediatric IPD cases were identified via enhanced passive surveillance of microbiology laboratory reports of pneumococcal isolates from sterile body sites of children younger than 18 years for 2 years starting in October 2001. Serotyping was performed on isolates of Streptococcus pneumoniae from normally sterile body fluid. Case demographic and clinical data (including dates of prior doses of PCV7) were collected via follow-up telephone interviews with case primary care providers and/or parents. RESULTS: Between October 1, 2001 and September 30, 2003, 191 cases of IPD were identified statewide (138 in children younger than 5 years). Annual incidence rate for IPD was 17.4 per 100,000 children younger than 5 years, representing a decline of 69% when compared with annual incidence rate of 56.9 per 100,000 from Massachusetts statewide active surveillance performed 1990-1991. In 2001-2003, 30% of cases occurred in the first year of life (36.5 per 100,000), representing a 7.8-fold increased risk compared with children older than 1 year of age. Race-specific annual incidence rates in blacks and Hispanics were 2.3-fold (95% confidence interval, 1.21-4.42) and 1.9-fold (95% confidence interval, 1.06-3.37), greater than in whites. Fifty-nine cases were reported to have underlying comorbid conditions. Serotyping was available for 136 of 191 (71%) cases younger than 18 years; of isolates available for serotyping, 40 (29%) were vaccine serotype (ST), 31 (23%) vaccine-related ST and 65 (48%) nonvaccine ST. Seven of 40 cases with IPD caused by vaccine ST received at least 3 doses of PCV7 vaccine before IPD. CONCLUSIONS: Universal administration of PCV7 to children younger than 2 years of age and selective administration to children 2-5 years of age has resulted in a significant decline in IPD in Massachusetts. Children younger than 1 year of age, African American and Hispanic children and those with recognized comorbid illnesses (malignancy, human immunodeficiency virus, immune deficiency, nephrotic syndrome, etc.) continue to remain at risk for IPD. These risk features should be considered when evaluating febrile infants and children.     

Inflammatory bowel disease in children and adolescents in Sweden, 1984-1995

BACKGROUND: A prospective study of inflammatory bowel disease (IBD) in Sweden was performed to investigate whether the incidence and morbidity have changed from 1984 through 1995. METHODS: Children 15 years of age or less with IBD were included--i.e., those with a definite diagnosis of ulcerative colitis (UC) and Crohn's disease (CD) and those classified as having indeterminate colitis (IC) and probable Crohn's disease (PCD). The study covered 56.5% of the pediatric population of Sweden. RESULTS: The diagnosis of IBD was made in 639 children, which corresponds to a mean annual incidence of 5.8 per 100,000. The incidence increased from 4.6 per 100,000 per year from 1984 through 1986 to 7.0 from 1993 through 1995. It reflected an increase in UC from 1.4 to 3.2 per 100,000 per year, which is a significant yearly percentage of increase (8%; confidence interval, 2-14%; P < 0.05). In contrast, no change occurred in the incidence of CD (1.2-1.3 per 100,000). The incidence of IC and PCD also remained fairly stable. The percentages of children who underwent surgery decreased from 17.3% in the first 6 years to 4.6% in the last 6 years (P < 0.001). Surgery was performed in 27.7% of CD and 5.3% of UC cases. The median age at diagnosis was 12.2 years for UC, 13.0 years for CD, 11.2 for IC, and 11.2 for PCD. At diagnosis, 48 children (7.5%) were 5 years of age or less, whereas most of the patients were 11 years of age or more (398 children, 62.3%). CONCLUSIONS: In Sweden, the incidence of UC has increased, whereas that of CD remains the same. A significant number of children were classified with IC and PCD. In most children, IBD was diagnosed when they were 11 years old or more, but some cases were detected even in those below 6 years of age. A decrease in the frequency of surgery occurred during the study.     

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.     

Rotavirus epidemiology of children in Bursa, Turkey: a multi-centered hospital-based descriptive study

In this multi-centered study, we aimed to evaluate the distributional incidence of rotavirus acute gastroenteritis (RVAGE) according to age groups and epidemiological features of hospitalized and outpatient cases in the city center of Bursa, Turkey. This study was carried out in a multi-centered setting that included the four largest hospitals dealing with more than 90% of the pediatric population in Bursa. Children under 15 years old with acute gastroenteritis (AGE) were included in the study. During a period of one year, all of the hospitalized AGE cases and initially one out of 15 systematically determined outpatien cases with AGE were included in the study. RV diagnosis was made by using monoclonal RV antigen kits (BioMêrieux, France) in fresh stool. Of 542,199 annual general hospital visits in those four hospitals, 5,988 were diagnosed with AGE (1.1%). The annual general AGE incidence in children under 15 years of age was found to be 1.7% per year. The annual incidence of RVAGE was 2.8%, 2.5%, 1.5%, and 0.14% in the cases aged < 1 year, < 2 years, < 5 years, and 5-14 years, respectively. The hospitalization rate of RVAGE was estimated to be 22.5%, 27%, 20%, and 12.5% in the cases aged < 1 year, < 2 years, < 5 years, and 5-14 years, respectively. RVAGE comprised 21% of the outpatient AGE cases and 0.35% of the total general pediatric outpatient cases. Acute gastroenteritis (AGE)-related hospitalizations comprised 5.7% and RVAGE-related hospitalizations 1.6% of all hospitalizations. RVAGE comprised 28.5% of all AGE hospitalizations. It was found that the annual RVAGE-related hospitalization incidence was 629/100,000 in those aged < 1 year, 553/100,000 in those aged < 2 years, 293/100,000 in those aged < 5 years, and 17/100,000 in those aged 5-14 years. Rotavirus acute gastroenteritis (RVAGE) in both hospitalized and outpatient cases was found to be higher (60%) in boys than girls. It was found that the RV positivity in hospitalized AGE cases was higher than in outpatient AGE cases (28.5% vs. 21%, p = 0.002). Eighty-six percent of hospitalized and 76% of outpatient RVAGE cases were < 5 years (p = 0.018). When the monthly distribution of RVAGE was examined in hospitalized and outpatient cases, it was found that RVAGE increased rapidly after October and decreased after March in cases aged < 5 years. The highest RV positivity rate was detected as 49.5% in January in hospitalized AGE cases and 31.5% in February for outpatient cases. In those < 5 years, the lowest RV positivity rate was detected in the June-September period both in hospitalized (between 11-25%) and in outpatient (between 0-18%) cases. Nearly half (47%) of the hospitalized RVAGE in those < 5 years were hospitalized in the January-March period. More than half of the outpatient RVAGE cases (55%) aged < 5 years were detected in the January-March period. No meaningful differences were found in the monthly distribution and in the monthly RV positivity rates between hospitalized and outpatient cases. In conclusion, RV was found to be a significant etiologic agent in hospitalize (28.5%) and outpatient (21%) AGE cases in Bursa. Nearly 80% of the RVAGE cases were aged < 5 years. Approximately half of the cases were seen in the January-March period. In January, half of the hospitalized cases and one-third of the outpatient AGE cases were RVAGE. Our findings have revealed a comparable pattern in RVAGE epidemiology in Bursa to that of the European countries and the United States.     

Increasing ampicillin-resistance rates in Hemophilus influenzae meningitis

We studied the epidemiology of reported Hemophilus influenzae meningitis in Colorado for the years 1977 through 1981. Of 340 culture-confirmed cases, 94% occurred in children less than 5 years old. A marked seasonal variation was present, with peaks in late fall-early winter and late spring. The percentage of H influenzae isolates resistant to ampicillin increased from 4.2% in 1977 to 31.3% in 1981. The incidence of reported disease in children younger than 5 years of age increased from 26 per 100,000 population in 1977 to 39 per 100,000 population in 1981, The overall case fatality rate was 5.2%; mortality was somewhat higher for persons with ampicillin-resistant infections (9.4%) than for those with ampicillin-sensitive infections (4.3%). Our results agree with previous reports of an increasing rate of ampicillin resistance in H influenzae meningitis and indicate a possible increasing incidence of this disease in Colorado.     

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。     

Surveillance of hemolytic uremic syndrome in children less than 15 years of age, a system to monitor O157 and non-O157 Shiga toxin-producing Escherichia coli infections in France, 1996-2006

BACKGROUND: Since the 1980s, Shiga toxin-producing Escherichia coli (STEC), especially E. coli O157:H7, has been an important cause of food borne disease in industrial countries. In France, as there was no routine screening for STEC in clinical laboratories, enhanced surveillance of hemolytic uremic syndrome (HUS) in children less than 15 years of age was established in 1996 to monitor trends in the incidence of STEC infections. METHODS: The surveillance system was based on a voluntary national network of pediatricians of 31 pediatric nephrology units in public hospitals. RESULTS: From 1996 to 2006, the mean annual incidence of HUS was 0.71 cases per 100,000 children less than 15 years of age and 1.87 cases per 100,000 children less than 5 years of age. STEC infections were confirmed in 66% of patients; STEC O157 was the most common serogroup identified in STEC-related HUS (83%). In this 11-year period, 96% of HUS cases were sporadic and only 2 outbreaks caused by STEC O157 and by a dual infection of STEC O26 and O80 were detected. CONCLUSIONS: An evaluation of the surveillance of pediatric HUS showed that it is a simple and useful system for monitoring trends in STEC infections in France. It provides the information needed to measure the impact of new and changing vehicles of STEC transmission, and evaluate the effectiveness of prevention measures.     

Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004

A hospital-based survey of Kawasaki disease was performed in all 45 hospitals with in-patient beds in Beijing during the 5-year period from 2000 through 2004. A total of 1107 patients were enrolled, with an annual incidence varying from 40.9 to 55.1 per 100,000 children <5 years of age. The incidence of coronary complications was 20.6% in the acute stage, and 6.9% in the 1-2 month follow-up.     

Epidemiology of invasive and other pneumococcal disease in children in England and Wales 1996-1998

The results of enhanced national surveillance of pneumococcal disease in children < 15 y of age in England and Wales are reported for the period 1996-1998. Of the 1985 cases of laboratory-confirmed invasive disease (annual incidence 6.6 per 100,000 overall and 39.7 per 100,000 in infants < 1 y of age), 485 (24%) were meningitis (annual incidence of 1.6 per 100,000 overall and 15.7 per 100,000 in infants <1 y of age). Fifty-nine deaths in children with invasive disease were identified-3% of the total reports. Thirty-one different serogroups/types were identified, with organisms in the 7-valent conjugate vaccine responsible for 69% of the infections in children < 5 y of age: this rose to 77% and 82%, respectively, for the 9-and 11-valent vaccines. Resistance to penicillin varied from 2.3% to 6.2% in different years, but erythromycin resistance remained constant at 17%. The vast majority of resistant isolates were in vaccine serotype/groups. Computerized hospital admission records for all children < 15 y of age with a discharge diagnosis code indicating probable pneumococcal disease were also analysed for 1997. The annual incidence for cases with a code specifically mentioning S. pneumoniae was 9.9 per 100,000 compared with 71.2 per 100,000 for lobar pneumonia; the mean duration of stay for both was < 1 wk. The incidence of admission for pneumococcal meningitis (1.9 overall and 19.6 for infants < 1 y of age) was similar to that derived from laboratory reports and resulted in an average duration of stay of 2 wk. CONCLUSION: This surveillance has confirmed the substantial burden of morbidity attributable to pneumococcal disease in British children and the potential public health benefits that could be achieved by the use of pneumococcal conjugate vaccines.     

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     

The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15?years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5?years of age, and 29.5% were in children under 1?year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15?years of age in Turkey, 21.7 to 28 per 100,000 children under 1?year of age, 9.8-13.8 per 100,000 children under 5?years of age, 3.96-6.52 per 100,000 children between 5 and 10?years of age and 0.42 to 0.71 per 100,000 children between 10 and 15?years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p?相似文献   

Invasive Haemophilus influenzae type b infections in children hospitalized in Hong Kong, 1986–1990

A 5-year territory-wide retrospective survey of invasive Haemophilus influenzae type b diseases was conducted in Hong Kong. Between 1986 and 1990, 57 cases (28 male) were recorded in children less than 12 years old (37 cases of meningitis, 9 of septicaemia and 11 of bacteraemic pneumonia). The annual incidence for children less than 5 years old was 2.7 per 10⁵ (95% confidence interval (CI) 2.0–3.5). Of the 57 cases, 39 were Chinese and 18 non-Chinese (7 Vietnamese refugees, 6 Caucasians, 5 others). The annual incidence in Vietnamese refugees less than 5 years old was 42.7 per 10⁵ (95% CI 17.2–87.9), giving a relative risk of 18.5 (95% CI 8.3–41.0). Chinese patients (68%) were under-represented as Chinese accounted for at least 94% of the population. Moreover, 14 of the 39 Chinese patients had pre-existing medical problems, compared with only 1 of the 18 non-Chinese patients (p = 0.022).     

Epidemiology of invasive Haemophilus influenzae type b infections in Bedouins and Jews in southern Israel

We report the epidemiology of invasive Haemophilus influenzae type b disease requiring hospital intervention in Southern Israel, an area that contains two ethnic populations, Bedouins and Jews. The study is based on 107 blood or cerebrospinal fluid culture-positive cases during the years 1984 to 1988. The annual incidence rate among children younger than 5 years of age was 51/100,000 (48/100,000 for Jews and 58/100,000 for Bedouins). Thirty-nine percent of patients had meningitis, 32% had pneumonia and 31% had otitis media. Epiglottitis was present in only one case (less than 1%). The median age was 8 months. Twenty-six percent of the cases were 6 months old or younger, 75% were 1 year old or younger and 87% were 18 months old or younger. Ninety-five percent of all meningitis cases occurred during the first 18 months of life. A projected number of 2938 hospitalization days and 9.8 deaths/year for a population in which 100,000 births occur yearly was calculated. The major impact of invasive H. influenzae type b infections and the very young age involved justify initiation of H. influenzae vaccine studies in our region.     

Epidemiological features of Kawasaki disease in Korea, 2006–2008

Background: The aim of this study was to estimate the incidence and describe the epidemiological characteristics of Kawasaki disease among children in Korea. Methods: Questionnaires for surveying the epidemiology of Kawasaki disease were distributed to a total of 101 hospitals that conduct pediatric residency programs. Then, we retrospectively obtained the data, which covered a three‐year period (2006–2008) and analyzed them. Results: During the three‐year study period, a total of 9039 cases of Kawasaki disease were reported from 84 hospitals (response rate, 83.2%), comprising 5375 boys and 3664 girls (male : female ratio, 1.47:1). The outbreak rate per 100 000 children <5 years old was 108.7 in 2006, 118.3 in 2007 and 112.5 in 2008 (average rate, 113.1). The seasonal distribution showed a slightly higher incidence rate in winter and summer. The patients’ mean age of onset was 32.6 months, while the proportions of sibling cases and recurrent cases were 0.17% and 2.2%, respectively. Coronary arterial abnormalities were detected during follow up by echocardiogram in 17.5% of all cases including dilatations (16.4%) and aneurysms (2.1%). Conclusions: The average annual incidence rate of Kawasaki disease in Korea has been continuously increasing, and reached 113.1/100 000 children <5 years old, which is the second highest rate in the world.     

Kawasaki disease in New Zealand

AIM: To determine the epidemiology, management and outcome of Kawasaki disease (KD) in New Zealand. DESIGN: Prospective audit using New Zealand Paediatric Surveillance Unit (NZPSU) Reports. SETTING: Single country 2-year epidemiological study. Patients: All patients diagnosed with KD in New Zealand reported to the NZPSU from January 2001 to December 2002. MAIN OUTCOME MEASURES: Incidence of KD; time to diagnosis; use of intravenous immunoglobulin; cardiac features and outcome. RESULTS: Forty-nine new cases were identified. The annual incidence was 8.0 cases/100,000 children aged less than 5 years. Age at onset was less than 5 years in 86% of cases. Incidence was 4.6/100,000 for children of European origin, 9.6 for Maori, 12.2 for Pacific Islanders and 32.2 for children of East Asian origin. KD was diagnosed at a median of 6 days from onset of illness. 89% had fever and four or more diagnostic features. All patients had at least one echocardiogram: There was one small (2%) coronary artery aneurysm only; 13 (26%) had mild coronary artery dilatation. Thirty-five per cent did not have an echocardiogram performed four or more weeks from illness onset. 45 (92%) cases received intravenous immunoglobulin at median day six. There was one death due to occlusive coronary artery disease in a 3-month-old boy with atypical symptoms in whom KD was diagnosed at post-mortem. CONCLUSIONS: The incidence of KD in New Zealand is defined with significantly variable risk according to ethnicity. Most patients received appropriate rapid diagnosis and treatment but there was considerable variation in practice in regard to number and timing of echocardiograms. There was a low coronary artery aneurysm rate (2%). Accelerated vaso-occlusive disease was responsible for the single fatality in an atypical case.