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Awareness of signs of Kawasaki Disease can save lives

A group of dedicated parents and former patients is seeking to raise awareness of a mysterious illness that comes on suddenly, usually strikes the very young and causes a host of unusual symptoms that can make a child miserable. Kawasaki Disease (KD) is a little-known illness that can lead to permanent heart damage or even take a young life if not diagnosed and treated in a timely manner.

Awareness of symptoms on the part of parents, prompt diagnosis and early treatment can save lives and prevent future health problems. To that end, the Kawasaki Disease Foundation held the first annual National Kawasaki Disease Awareness Day on January 26, 2011.

The illness is named after Dr. Tomisaku Kawasaki of Japan, who saw his second patient with the telltale signs of the disease on this date in 1961.

“KD is the No.1 cause of acquired heart disease in children. That’s why we want parents to know and recognize the signs of the illness and take their child to the doctor immediately if he or she has persistent fever and other symptoms,” said Greg Chin, president of the Kawasaki Disease Foundation. His son had the disease, but fully recovered.

The illness involves an inflammation of blood vessels throughout the body. More than 80 percent of patients are under age five, although older children and teenagers can also get KD.

The hallmark of the disease is a fever that lasts for several days. Other early signs include a rash; red eyes, without drainage or crusting; bright red, swollen, cracked lips; “strawberry tongue”, which appears with shiny bright red spots after the top coating sloughs off; swollen hands and feet; redness of the palms and soles of the feet; and swollen lymph nodes in the neck. Most children are extremely irritable.

“Unfortunately, untreated Kawasaki Disease can cause serious problems later in life,” said Jane C. Burns, M.D., director of the Kawasaki Disease Research Center at Rady Children’s Hospital and the University of California in San Diego. The disease is most often misdiagnosed or overlooked in infants and teenagers, but it can be missed in young children as well.

Prompt diagnosis and timely treatment are important to prevent complications affecting the heart arteries, according to Burns. Children are hospitalized and receive an intravenous treatment called gamma globulin. The goal is provide the treatment within 10 days of developing the illness.

Uma O’Donnell of Manhasset, Long Island, says when her son Nick came down with Kawasaki Disease at age five, eight doctors failed to make the correct diagnosis. Although it was 10 years ago and her son is now in good health, she says it was a nightmare she and her husband, Vincent, will never forget. “It was horrific for the whole family,” she says.

O’Donnell, trained as a respiratory therapist, says she knew something was terribly wrong with Nick, yet her son’s pediatrician at the time refused to take her seriously. Despite Nick’s unrelenting fever and numerous symptoms pointing to KD, she says the pediatrician dismissed his illness as a virus that would run its course.

As his symptoms got worse, the family took him to the emergency room connected to a local children’s hospital every day for almost a week, where numerous physicians also said he had a virus and sent him home. Finally, O’Donnell was referred to a Great Neck pediatrician, who made the correct diagnosis. Her son was hospitalized and received the intravenous treatment for KD 10 days after his symptoms began, and he finally started to recover.

More than 5,500 children were hospitalized in the United States for the illness in 2006, the most recent year for which statistics were available from the Centers for Disease Control. But the number is probably higher, according to Burns, because it does not include all hospitals nationwide and some cases are never diagnosed.

Children of all races and ethnicities are affected. Without treatment, about 25 percent of children develop heart disease involving the coronary arteries.

Despite several years of research, the cause remains a mystery. At the moment, there is no specific test, such as a blood test or throat culture, to diagnose it. The doctor makes the diagnosis based on the child’s symptoms, in addition to laboratory tests that show inflammation.

The KD Foundation has designed a poster depicting the signs and symptoms of the illness. It is available to doctors’ offices, hospitals and clinics upon request. A printable version is also available on the foundation web site. A wealth of information, including an information packet and newsletter, is also available at www.kdfoundation.org.