Epidemiology of Kawasaki Disease in a Large Urban Center in the United States Over a 21 Year Period

Abstract

Previous studies on the epidemiology of Kawasaki disease (KD) in the US have been limited to reports on epidemics or the epidemiologic characteristics of the illness in various populations over limited periods of time. Childrens Hospital Los Angeles is a 314 bed teaching hospital which serves a large urban, multi-ethnic population. We describe the epidemiology of KD in our hospital from 1979 through 2000 in a population of 980 KD patients seen over that period. We discuss trends in incidence, age, gender, ethnicity, geographic distributon, seasonality, and birth cohort information in this group of patients. We also describe clinical characteristics including rates of recurrence, incidence of cardiovascular abnormalities, myocardial infarction, and mortality. Results of theraputic interventions are detailed especially with regard to the use of intravenous gamma globulin and steroids. In addition, information on the occurence of KD in Los Angeles County obtained from government databases for the years 1989 through 1999 is evaluated for the incidence, age, ethnicity, geographic distribution, and other epidemiologic characteristics. Trends in the two populations are compared to determine if information derived from our population is representative of that of the population as a whole. This would allow for on going surveillance of KD in this large urban county by reporting from a single hospital site and inferring epidemiologic trends observed to the rest of the population. Since KD is greatly under reported in Los Angeles County at present, this would improve our understanding of its epidemiology here substantially.