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Epidemiology of Kawasaki Disease
Hung-Chi Lue, MD, PhD 1, 2, Saji Philip MD1 , Hsu Ming-Chia, MD1,
Jou-Kou Wang, MD, PhD 2, Mei-Hwan Wu MD, PhD 2.
Department of Pediatrics, Min-Sheng General Hospital 1 and
National Taiwan University Hospital2, Taiwan
Abstract:
Objective: To report the epidemiology of Kawasaki disease (KD)
based on the Taiwan experiences and a review of the literature.
Methods: We conducted four nationwide surveys on the number
of patients encountered in hospitals of 100 or more beds with
pediatric services in Taiwan. The first survey covered 1976-1986,
the second survey 1987-1991, the third survey 1992-1993 and the
fourth survey 1994-2000. The annual incidence of KD was expressed as
the number of KD patients per 100,000 children less than 5 years of
age. The literature on the incidence of KD was reviewed, compared
and discussed.
Results: In Taiwan, the first case of KD was encountered in
1976, and the number of patients increased thereafter, to 440 in
1986, 512 in 1993, 736 in 1996, 838 in 1998, and 792 in 2000. The
incidence increased to 24.8 in 1986, 31.6 in 1993, 46.3 in 1996,
then to a peak of 54.3 in 1998. Male to female ratio ranged 1.5
to1.7 with an average of 1.6. The percent frequency of patients aged
below 2-years ranged 57.6%-65.2%, average 59.8%; 2 to 4-years
23.3%-26.5%, average 25.3% and above 4 years 13.1%-15.8%, average
14.9%. Early coronary artery lesions were present in 27.2% to 31.5%,
average 25.9% of the patients.
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The fatality rate decreased from 0.4% in the first survey to 0.06%
in the fourth survey. The peak incidence observed in the past, was
the highest, 194.7 in Japan, second highest 54.3 in Taiwan, followed
by 38.9 in Korea, and 32.0 in Hong Kong, China, in the South-East
Asian region. In the other regions of the world, the highest was
47.7 in Hawaii, USA, then 20.6 in Ontario, Canada.
Conclusions: KD affects mainly infants and children, most frequently
in Japan, then in Taiwan, Hawaii, Korea, Hong Kong, Ontario and
Beijing. The etiology of KD is still unknown.
Key words: Kawasaki disease, coronary artery lesions,
epidemiology, Taiwan, the world
Corresponding author:
Hung-Chi Lue, MD, PhD, FACC
Emeritus Professor of Pediatrics, National Taiwan University
President, Association of Pediatric Societies of South East Asia
Region
Director, Min-Sheng General Hospital
168, Ching-Kuo Rd, Tao-Yuan 330, Taiwan
Fax: + 886-3-3164336, Tel: + 886-3-316-4307
E-mail: hclue@e-ms.com.tw
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