Kawasaki disease is a rare but serious illness. It usually affects younger tamariki under the age of 5 years. The name of the disease comes from Tomisaku Kawasaki, the Japanese doctor who first described it in 1967.
Kawasaki disease causes high fevers that last at least 5 days. If left untreated, about 1 in 5 tamariki with Kawasaki disease will suffer damage to their heart. It can also cause damage to other parts of the body.
The cause of Kawasaki disease is unknown. It is more common in Japan than in most other countries.
One theory is that a common virus or other common infection causes an over-reaction in the infection-fighting system (immune system) of some tamariki.
Your child cannot 'catch' Kawasaki disease - it is not contagious.
Without treatment, Kawasaki disease can last for 10 days or more.
If the disease affects the heart, then the damage can be permanent.
Tamariki of Asian and Pacific descent are at greater risk. Most tamariki who get Kawasaki disease are under the age of 5 years.
If a child has had Kawasaki disease, there is a slightly higher chance that their brothers or sisters will get it. The risk is higher again for twins - a 1 in 10 chance.
The most striking feature of Kawasaki disease is a high fever that comes and goes for at least 5 days. Tamariki are usually very irritable and easily upset.
Other symptoms of Kawasaki disease include:
There are many other possible signs and symptoms including tummy pain, vomiting, diarrhoea, and joint pain and swelling.
If you think your child might have Kawasaki disease, you should take them to your doctor straightaway.
You should also see your doctor if you are not sure what's wrong with your child, but they:
There is no single test that can diagnose Kawasaki disease. Your doctor will consider other possible illnesses as well. The diagnosis can be difficult to make. A paediatrician (children's health doctor) in hospital will usually confirm a diagnosis of Kawasaki disease.
For your child to have a diagnosis of Kawasaki disease, they will usually have a fever for at least 5 days and at least 4 of the symptoms listed above. Babies with Kawasaki disease may not have as many of the symptoms as older tamariki. The symptoms may not all be present at the same time.
Blood tests may help make the diagnosis.
Once diagnosed with Kawasaki disease, your child will need an ultrasound scan of the heart (echocardiogram) to check whether the disease has affected their heart. This is a safe and painless scan. It is similar to the ultrasound scan women have when pregnant. This ultrasound may happen in hospital or after your child has gone home from the hospital.
If your child has Kawasaki disease, the doctors taking care of them will discuss with you what treatment and follow-up your child needs. If you don't understand the plan for your child, it is OK to ask.
Immunoglobulin is a blood product made of concentrated antibodies from donated blood. Your child will receive it through a vein (intravenously).
Immunoglobulin is very effective at reducing the risk of heart damage. It works best when given within 10 days of the start of the illness. With treatment within 10 days, immunoglobulin reduces the chance of heart damage to 1 in 50. Without treatment, the chance of heart damage is about 1 in 5.
After your child has had immunoglobulin treatment, they shouldn't have the measles, mumps, rubella (MMR) or chickenpox (varicella) vaccines for 11 months. That's because these vaccines may not work properly after immunoglobulin. Your child can have all the other vaccines, including the influenza vaccine, at the normal time. Immunoglobulin won't affect how these vaccines work.
Some tamariki may need a second dose of immunoglobulin if their symptoms have not improved after the first dose.
Your child's doctor will prescribe aspirin in case there has been heart damage. Your child will keep taking aspirin at least until they have an ultrasound scan of their heart.
If your child needs to keep taking aspirin after going home from hospital, there are some important things to remember.
Don't give your child anti-inflammatory medicine and aspirin
Your child should not take ibuprofen or other anti-inflammatory medicine while they are taking aspirin.
If your child gets the flu or chickenpox, they may need to stop taking their aspirin
This is to avoid a condition called Reye syndrome - a rare and serious illness linked to aspirin use in children with fever.
See your doctor immediately if your child gets a fever while on aspirin and ask about this.
See the KidsHealth page on fever [1].
If your child gets a fever again within 6 weeks of having Kawasaki disease, take them to see your family doctor (GP). Your child may need to go back to hospital.
It is very unusual to have Kawasaki disease more than once. This only happens to about 3 in 100 tamariki who have had Kawasaki disease.
There is no way to prevent Kawasaki disease. Appropriate treatment given early enough in the illness will help prevent complications.
The major complication of Kawasaki disease is heart damage. The most common type of heart damage is caused by irritation or inflammation of the vessels that carry blood to the heart muscle. Immunoglobulin works by reducing the inflammation and preventing the damage.
If damage does occur, your child needs regular health checks by a doctor. After a few years, the heart damage heals in about half of all affected tamariki.
There are other treatments available for tamariki with severe damage to their heart.
Illustrations by Dr Greta File. Property of KidsHealth.
This page last reviewed 22 September 2023.
Email us [2] your feedback
Links
[1] https://www.kidshealth.org.nz/fever
[2] https://www.kidshealth.org.nz/contact?from=http%3A%2F%2Fwww.kidshealth.org.nz%2Fprint%2F53%3Flanguage%3Dko