Kawasaki disease in Hong Kong, 1994 to 2000

Abstract

Objective: To describe the epidemiology, clinical characteristics, and management of Kawasaki disease in children in Hong Kong.

Design: Retrospective survey of medical records from July 1994 to June 1997, and prospective data collection from July 1997 to June 2000.

Setting: Hospitals with a paediatric unit in Hong Kong.

Patients: Patients diagnosed with Kawasaki disease between July 1994 and June 2000 in public hospitals in Hong Kong.

Main outcome measures: Incidence of Kawasaki disease and coronary artery aneurysm rates.

Results: A total of 696 cases of Kawasaki disease were reported. There were 435 (62.5%) boys and 261 (37.5%) girls giving a male to female ratio of 1.7:1. The age ranged from 1 month to 15 years 5 months with a median of 1.7 years. Infants (<1 year) constituted the largest group of patients (223, 32.0%) and overall, 638 (91.7%) were younger than 5 years. Skin rash, conjunctivitis, and oral signs were among the principal clinical features present in over 80% of cases. Prominent cervical lymph nodes larger than 1.5 cm were less commonly found (24%). Coronary artery aneurysms or ectasia were present in 15.7% (109/696), 8.5% (59/696), and 5.0% (35/696) of patients at 2, 4, and 8 weeks, respectively. The incidence of Kawasaki disease per 100,000 children under 5 years was significantly higher in the prospective study period than in the retrospective period (39 vs 26, P<0.001).

Conclusion: The incidence of Kawasaki disease is high in Hong Kong and is 39 per 100,000 children below 5 years of age. The coronary artery aneurysm prevalence is 5%. Intravenous gamma-globulin and high-dose aspirin is the mainstay of treatment.