Kawasaki Disease: What Every Parent Needs To Know
Children tested positive for COVID-19 are showing symptoms of the Kawasaki disease, and doctors are concerned.
Kawasaki disease is a rare medical condition affecting children. There is also no known cause of the illness. The disease is so rare that there are a lot of questions surrounding it. What is Kawasaki disease? Is Kawasaki disease contagious? What are its symptoms?
In order to help parents have a better understanding of this medical condition and become more aware of this disease affects children, we put together information parents need to know about Kawasaki disease.
What is Kawasaki Disease?
Kawasaki disease is an illness that usually affects children less than 4 years old, though older children may get it too. It can be more serious in children under the age of 1. This rare childhood illness causes inflammation of the blood vessels, resulting in fever and joint pain.
The term was first described by Tomisaku Kawasaki, a Japanese paediatrician, in 1967.
The mysterious illness involves the mouth, skin and lymph nodes, and mostly affects young children up to the age of 5 and a small percentage of teenagers.
Researchers believe that it could probably be triggered by a virus infection. Though its exact cause is unknown, early diagnosis is key.
If detected early, it can be treated without any problems with intravenous (IV) gamma globulin and aspirin. However, if left untreated, it can lead to serious heart disease or other complications that can be life-threatening.
Other Symptoms of Kawasaki Disease
The symptoms of this disease often appear in phases. The first phase can involve a fever that lasts for at least 5 days. This phase of the disease can last for up to 2 weeks.
Important note: The following key signs and symptoms may not be present at the same time. Only a few of these symptoms actually develop in some very young infants.
The symptoms in the first phase include:
- High fever (above 101F or 38.3 degrees Celsius) – does not reduce even with medication and lasts for more than 5 days
- Swollen lymph glands in the neck
- Rash in the genital area, stomach and chest
- Dry, cracked and red lips, and a swollen tongue
A telltale symptom such as a “strawberry tongue” can sometimes appear in the early stages.
- Swollen red palms of hand and soles of feet
- Redness in both eyes
- Irritation and inflammation of the lips, mouth and throat
The symptoms in the second phase include:
Once a child with this disease enters the second phase, large portions of their hands and feet may begin to peel. This alarming symptom may also be accompanied by diarrhoea, vomiting, joint pain and abdominal pain.
- Joint pain
- Pain in the belly
- Diarrhoea and vomiting
- Peeling of skin on hands and feet
In rare cases, children can have:
- Unusual heart rhythms
- Inflamed heart muscles
- Damaged heart valves
- Weak or bulging artery walls
If suspected, the doctor may advise for a blood or urine test. An echocardiogram may also be ordered to evaluate the heart’s coronary arteries. Usually, no heart problems are developed if treated within the first 10 days.
In the case of incomplete Kawasaki disease, signs and symptoms of the disease may not all be present, but appear as different combinations in different patients, said Prof Quek Swee Chye, who heads the National University Hospital’s division of paediatric cardiology. “The sequence of when the signs evolve does not follow a pattern,” he told The Straits Times in an interview.
Treatments for Kawasaki Disease
To help reduce the risk of complications brought about by this medical condition, Professor Quek said appropriate treatment “using intravenous immunoglobulins and high-dose aspirin” may be provided to children with Kawasaki disease.
He noted that treatment should be initiated within 10 days of the illness and can be started as “soon as the disease is confidently diagnosed.” He also said that “some doctors would still consider giving medication beyond 10 days if there is evidence of active inflammation.”
Is Kawasaki Disease Contagious?
According to the United Kingdom’s National Health Service (NHS), symptoms of Kawasaki disease are similar to those of an infection, so it is likely to be caused by a bacteria or a virus. “But so far a bacterial or viral cause hasn’t been identified,” it said.
It also noted that Kawasaki disease isn’t contagious, therefore it cannot be passed from one person to another. “This makes it unlikely that it’s caused by a virus alone,” it added.
While it is non-contagious, it can sometimes show up in clusters within a community.
Kawasaki Disease In Singapore
According to this SingHealth website, the incidence of Kawasaki disease in Singapore is estimated at 51.4 per 100,000 children ≤ 5 years of age.”
Associate Professor Tan Teng Hong, Head and Senior Consultant, Cardiology Service, KK Women’s and Children’s Hospital (KKH), said the hospital “sees an average of 120 new cases per year of which about half are below the age of 21.”
“The younger the age group, the higher the incidence, and more than 90 per cent of our patients with Kawasaki disease are 5 years old or younger,” Prof Tan added.
Kawasaki Disease And Coronavirus
Health officials in several countries like the UK, Italy, Spain, France, Belgium and Switzerland have reported a rise in cases resembling the Kawasaki disease in kids, and all these kids were exposed to the coronavirus.
The number of such cases are gradually increasing and medical experts are investigating the link between the two. In the UK, Kawasaki disease-type of symptoms were reported in at least 12 children, and in France, about 20 children between 3 to 17 years of age were showing symptoms associated with the Kawasaki disease.
Doctors at the Necker-Enfants Malades Hospital in Paris believe that it might be a post-coronavirus infection disease, where the body’s immune system overreacts due to the infection. Although Damien Bonnet, Head of the Department of Paediatric Medical Cardiology, says that the disease mostly followed COVID-19, he also added that there is no certainty that there is a direct link between the coronavirus and the symptoms of the Kawasaki disease that were found in the children.
The World Health Organisation is investigating the possibilities of the link between COVID-19 and Kawasaki disease.
In Singapore, the Ministry of Health (MOH) said no children who have contracted COVID-19 has suffered from serious inflammatory symptoms
Covid-19 has infected 57 children aged 16 and younger—in Singapore—since the outbreak began in January.
MOH said none has had to be in the intensive care unit.
As of 6 May, 42 of these cases involving children have recovered.
Lead image photo courtesy of Kawasaki Disease Foundation.