Background: The aim of this study was to estimate the incidence and describe the epidemiological characteristics of Kawasaki disease among children in Korea. Methods: Questionnaires for surveying the epidemiology of Kawasaki disease were distributed to a total of 101 hospitals that conduct pediatric residency programs. Then, we retrospectively obtained the data, which covered a three-year period (2006)(2007)(2008) The seasonal distribution showed a slightly higher incidence rate in winter and summer. The patients' mean age of onset was 32.6 months, while the proportions of sibling cases and recurrent cases were 0.17% and 2.2%, respectively. Coronary arterial abnormalities were detected during follow up by echocardiogram in 17.5% of all cases including dilatations (16.4%) and aneurysms (2.1%). Conclusions:The average annual incidence rate of Kawasaki disease in Korea has been continuously increasing, and reached 113.1/100 000 children <5 years old, which is the second highest rate in the world.

The average annual incidence of KD in South Korea has continuously increased to 134.4 per 100,000 children <5 years of age in 2011, which is the second highest incidence of KD worldwide, following its incidence in Japan.

The average annual incidence, 86.4/100 000 in children <5 years old is the second highest rate in the world.

Background and ObjectivesThis study is aimed at elucidating potential temporal associations between the occurrence of Kawasaki disease (KD) and various viral infections.Subjects and MethodsWe obtained monthly patterns of KD from the seventh nationwide survey and viral detection data from the Korea Centers for Disease Control and Prevention from 2009 to 2011 and evaluated temporal correlations between them for each month. The respiratory viruses detected using a multiplex real-time-polymerase chain reaction kit were influenza virus (A/H1N1, A/H3N2, A/H5N1, and B), adenovirus, parainfluenza virus (type 1, 2, 3), respiratory syncytial virus (type A, B), human rhinovirus, human coronavirus (OC43/229E, NL63), human bocavirus, and enterovirus.ResultsWe obtained data from a total of 13031 patients who were treated for acute KD from 87 hospitals with pediatric residence programs. During this survey, KD showed highest overall incidence in summer and winter seasons and lowest incidence in February and October. We received viral detection data for a total of 14267 patients. Viral detection was highest during winter and spring seasons. The most commonly detected virus was human rhinovirus (32.6%), followed by influenza virus (26.8%). The monthly incidence of KD showed significant correlation with the monthly overall viral detection (p=0.022, r=0.382). In particular, human bocavirus and enterovirus have significant correlations with monthly patterns of KD occurrence (p=0.032 and p=0.007, respectively) and influenza virus correlated with KD occurrence with borderline significance (p=0.063).ConclusionThe temporal association between monthly occurrence of KD and viral detection suggests the etiologic importance of precedent infection in the development of KD.

We performed a retrospective epidemiologic survey on Kawasaki disease (KD) from 1997 to 1999 in Korea. We sent a questionnaire to 111 training hospitals, and summarized the data from 50 hospitals that responded. Data from a total of 3,862 cases were collected, which showed no difference in annual incidence and a seasonal predilection for summer. The male-to-female ratio was 1.51:1, and the mean age was 29.7 months. The prevalence of sibling cases was 0.26%, and the rate of recurrent cases was 2.3%. The proportion of patients with KD among total hospitalized pediatric patients was 1.19% in average, showing a significant difference according to the regions. Coronary arterial (CA) abnormalities were detected by echocardiography in 19.8% of cases (737/3,723) including dilatations in 601 cases (16.1%) and aneurysms in 191 cases (5.1%). Data from total 8,251 cases in the 1990s including the cases in the present study, in Korea showed a mean age of patients 28.9 months, male-to-female ratio 1.6:1, seasonal predilection for summer, prevalence of sibling cases 0.24%, rate of recurrent cases 2.3%, incidence of CA abnormalities 21.0%, and incidence of CA aneurysms 5.2%, with statistically significant decreasing trends in the male-to-female ratio and the rate of CA abnormalities.