Abstract
Kawasaki disease (KD)is an idiopathic acute febrile illness that primarily occurs in children <5 years of age and can lead to artery lesions if not promptly treated. Recent studies have shown possible correlations between KD onset and currents and air pollutants.The present study describes results on the correlation between environmental conditions, frequency, and variability ofKD onset in children under five years of age in Emilia-Romagna, a region of Northern Italy, over the period from 2000 to 2017. Since there are substantial climatic differences between the western-central (Emilia) and the eastern area (Romagna) of the region, the data for these areas are analyzed separately. The environmental factors considered are observed local surface daily temperature, daily precipitation, upper air wind regimes, and local air pollution. The results indicate that in Emilia-Romagna, KD onset occurs mainly during late autumn and early spring, which is in agreement with the literature. The frequency of KD onset in Emilia is significantly higher in months characterized by a high frequency of southerly flow, which is associated with milder than average night-time temperature, and in years with a prevailing south-westerly mean flow. These results are consistent with other studies, suggesting that certain wind conditions are more favorable for disease onset, which are possibly associated with one or more airborne agents.
Highlights
Kawasaki disease (KD) is an acute and self-limited vasculitis that affects children under 5 years, leading to coronary arteries alterations in about 15%−25% of cases if not promptly treated [1]
The purpose of the present study is to describe the correlations between KD onsets in Emilia-Romagna, a region of Northern Italy, and the variability of local climate in terms of wind direction and intensity, surface temperature, precipitation and local density of environmental pollutants, like urban and rural air concentration of particulate matter, detected at local air quality, and meteorological stations
Mean numbers over the period are close to 15 onsets per year, which is in agreement with the literature, and greater than the mean number of onsets per year in northern European countries [20]
Summary
Kawasaki disease (KD) is an acute and self-limited vasculitis that affects children under 5 years, leading to coronary arteries alterations in about 15%−25% of cases if not promptly treated [1]. The disease has been reported worldwide with different incidences in different countries [1], but it is known to be more common in East Asianpopulations with a peak of 309/100,000 cases for children under 5 years of age in Japan [2]. In Europe, the incidence of KD is variable from 5 to 16 cases per 100,000 children under 5 years of age. A recent Italian study [3] reports the incidence under 5 years of age in the Emilia-Romagna region as equal to 16.4 cases over the 2011 to 2013 period, with a peak in winter to early spring and a fall in the summer. Recent epidemiological studies have focused on some potential environmental risk factors for KD and the analyses have correlated the incidence of KD cases in Japan, Hawaii, and San Diego with tropospheric
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