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

Yahui T. Lin, Cedric Manlhiot, Joyce C.Y. Ching, Ra K. Han, Lynne E. Nield, Rejane Dillenburg, Dion Pepelassis, Lillian S. Lai, John F. Smythe, Nita Chahal, Rae S.M. Yeung, Brian W. McCrindle

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)699-706
Number of pages8
JournalPediatrics International
Volume52
Issue number5
DOIs
StatePublished - Oct 1 2010
Externally publishedYes

Keywords

  • coronary vessel anomalies
  • epidemiology
  • i.v. immunoglobulins
  • mucocutaneous lymph node syndrome
  • pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Lin, Y. T., Manlhiot, C., Ching, J. C. Y., Han, R. K., Nield, L. E., Dillenburg, R., Pepelassis, D., Lai, L. S., Smythe, J. F., Chahal, N., Yeung, R. S. M., & McCrindle, B. W. (2010). Repeated systematic surveillance of Kawasaki disease in Ontario from 1995 to 2006. Pediatrics International, 52(5), 699-706. https://doi.org/10.1111/j.1442-200X.2010.03092.x