Epidemiology of Kawasaki Disease in South Korea: A Nationwide Survey 2015–2017

Abstract

Background: This study aimed to investigate recent epidemiologic features of Kawasaki disease (KD) in South Korea. Methods: The ninth triennial nationwide questionnaire survey collected data on the demographic findings, symptoms and signs, treatment patterns and coronary artery complications of acute-phase KD occurred in 2015–2017 from 98 hospitals with pediatric residency programs and 108 community hospitals without residency programs. Results: We received data from 93 of the 98 hospitals (response rate: 94.9%) with residency programs and 75 of the 108 community-based children’s hospitals (response rate: 69.4%) without residency programs. In the 3-year survey period, a total of 15,378 (5449 in 2015, 5171 in 2016 and 4758 in 2017) cases of KD were reported. The mean age at diagnosis was 33.0 ± 24.8 months (range: 0–205 months), and the male-to-female ratio was 1.41:1. The overall KD incidence was 196.9 (202.2 in 2015, 197.1 in 2016 and 191.0 in 2017) per 100,000 younger than 5 years population. Recurrent cases were 4.85%. KD occurred more frequently during winter (December–January) and late spring (May–June). Intravenous immunoglobulin (IVIG) was administered to 95% of the patients; nonresponder rate for the first IVIG was 14.8%. Coronary artery aneurysms and giant coronary artery aneurysms (internal diameter >8 mm) occurred in 1.7% and 19 patients, respectively. Two patients died due to multiorgan failure and hepatic encephalopathy. Conclusion: Peak incidence of KD in South Korea was 202.2 per 100,000 younger than 5 years population (2015), and the incidence of giant coronary artery aneurysm decreased to 0.09% (2017).

Epidemiology of Kawasaki Disease in Europe

“…The disease is described in all continents but with variable frequency. The highest annual incidence is in Asian countries, and the latest published rate (per 100,000 children under 5 years old) seems to progressively decrease from 359 in Japan, 197 in South Korea, and 95 in Shanghai to 75 in Taiwan (2)(3)(4)(5). In non-Asian countries, the annual incidence is about 10-20 per 100,000 children under 5 years old, as described in North America, Europe, Chile or Australia (6,7).…”

“…Family forms are rare (2% in siblings, 1% in parents) (2). Many countries have reported an increased incidence of KD over the last decades (2)(3)(4)(5)12). Whether this increase is real or due to increased physician awareness is unclear.…”

“…Whether this increase is real or due to increased physician awareness is unclear. In South Korea, Shanghai and Taiwan, incidence rates seem to have stabilized in the last years (3)(4)(5). In Japan, where there is a long-standing widespread physician awareness of the disease, the increased incidence might be due to a true increase in case numbers.…”

Identifying Circulating MicroRNA in Kawasaki Disease by Next-Generation Sequencing Approach

“…KD is clinically diagnosed using several typical criteria, such as prolonged fever, oral mucosal changes, conjunctivitis, polymorphous rash, extremity changes, and lymphadenopathy [2]. Taiwan has the third-highest incidence of KD in the world, with 60 cases per 100,000 children [3][4][5]. Approximately 15-25% of children with KD are likely to develop coronary artery lesions (CALs); however, intravenous immunoglobulin (IVIG) treatment can reduce the frequency of CALs to 5% [2,3,[6][7][8][9][10][11].…”

“…Taiwan has the third-highest incidence of KD in the world, with 60 cases per 100,000 children [3][4][5]. Approximately 15-25% of children with KD are likely to develop coronary artery lesions (CALs); however, intravenous immunoglobulin (IVIG) treatment can reduce the frequency of CALs to 5% [2,3,[6][7][8][9][10][11]. The etiology of KD remains unknown.…”