Epidemiologic features of Kawasaki disease distinguished by seasonal variation: an age-specific analysis

Ozeki, Yukie; Yamada, Fumiya; Saito, Akinobu; Kishimoto, Tsuyoshi; Yashiro, Mayumi; Makino, Nobuko; Nakamura, Yosikazu

doi:10.1016/j.annepidem.2018.08.004

Cited by 16 publications

(13 citation statements)

References 15 publications

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“…Furthermore, Ozeki et al . reported that age differences in seasonal variation were identified on age‐specific analysis of KD, and that therefore the distribution of infectious agents would differ according to age . These data support the hypothesis that several infectious agents (some prevalent in winter and others in another period) should be taken into consideration in the etiological mechanism.…”

Section: Discussionmentioning

confidence: 90%

Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015–2016

Makino

Nakamura

Yashiro

et al. 2019

Pediatrics International

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177

163

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Background: Approximately 50 years have passed since Kawasaki disease (KD) was first reported. The KD nationwide survey began in 1970. Although >360 000 cases have already been reported in Japan, the cause is still unknown. In Japan, the number of patients and incidence rate of KD has continued to increase. It is necessary to examine the trend of the occurrence in the surveillance of KD. Methods: The nationwide survey of patient incidence in 2015 and 2016 was conducted in 2017, as the 24th nationwide survey of KD. A questionnaire was sent to pediatric departments in hospitals with >100 beds and specialized pediatric hospitals, and was responded to by the attending pediatricians. Results: The total number of patients in 2 years was 31 595, and the sex ratio (male/female) was 1.34. The incidence rate (/100 000 children aged 0-4 years/year) was 330.2 (371.2 in boys, 287.3 in girls) in 2015, and 309.0 (343.2 in boys, 273.2 in girls) in 2016. The number of patients by month peaked in January. The age-specific incidence rate according to sex was highest in children between 9 and 11 months of age, after which the incidence rate gradually decreased with advancing age. Conclusions: We summarize the most recent nationwide survey of KD and consider the change in the epidemiologic picture.

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Section: Discussionmentioning

confidence: 90%

Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015–2016

Makino

Nakamura

Yashiro

et al. 2019

Pediatrics International

Self Cite

177

163

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“…J o u r n a l P r e -p r o o f by Dr Tomisaku Kawasaki in 1967. 11 Previous studies strongly support that infectious agents trigger an abnormal acute immune response of KD, according to epidemiologic characteristics such as the age distribution, with the highest susceptibility among children aged <2 years and lowest in those aged <6 months, compatible with infection by a ubiquitous agent resulting in increasing immunity with age and with transplacental immunity; [1][2][3][4][12][13][14] occurrence through potential sibling-to-sibling transmission inside households; 13,[15][16][17][18] temporal-and municipallevel clustering; [19][20][21] seasonal difference in occurrence; [21][22][23][24][25][26] ; and epidemics observed during the past 50 years in Japan (1979, 1982, and 1986). [1][2][3][4] Recent studies have reported that the incidence of KD decreased during the coronavirus disease 2019 (COVID-19) pandemic period compared with the corresponding period in previous years.…”

Section: Discussionmentioning

confidence: 99%

Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic

Shibata

Kosami

et al. 2021

The Journal of Pediatrics

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…23 The seasonality of KD may be related to various infectious agents that act as a trigger in susceptible children. 7,8,[10][11][12][23][24][25]29 The etiology of KD onset is thought to involve gene-environmental interactions 7,37 and patients affected at ages younger or older than the peak age of onset may also have characteristic genetic factors. 37 More recently, an age-stratified genome-wide association study targeting both Korean and Japanese populations suspected a rare non-synonymous SNP (rs4365796) in the lymphoid enhancer binding factor 1 gene to be a susceptibility gene to specifically affect KD patients younger than 6 months of age.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] However, previous epidemiological studies have demonstrated seasonal variations of KD onset. 7,8,[10][11][12][13] KD mainly affects children younger than 5 years. 1,8 As for the initial treatment in the acute phase of KD, the level of evidence regarding the efficacy of intravenous immunoglobulin (IVIG) treatment in preventing the development of KD-related coronary aneurysms is robust (first-line IVIG treatment: class Ia, grade A).…”

Section: Introductionmentioning

confidence: 99%

Seasonal Variation in Epidemiology of Kawasaki Disease-Related Coronary Artery Abnormalities in Japan, 1999–2017

Kitano

Takeuchi

Suenaga

et al. 2021

Journal of Epidemiology

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Background: Epidemiological studies show a U-shaped tendency in Kawasaki disease (KD)-related coronary artery abnormalities (CAAs) across age categories. Since studies suggest seasonal variations in KD onset, this study aimed to clarify the epidemiologic features of CAAs, considering the seasons of KD-occurrence. Methods: We analyzed 2,106 (males = 1,215, females = 891) consecutive KD cases from October 1999 through September 2017 using our electronic database of annual surveys, targeting all hospitals with pediatric departments across Wakayama, Japan. The primary outcome was the presence=absence of CAAs measured by echocardiography 1 month after KD onset. Odds ratios (ORs) and 95% confidence intervals (CIs) of combined patient age and sex for CAAs were calculated using logistic regression models adjusted for four seasons. Results: The median age was 25 (range, 1-212) months. The proportion of males decreased with increasing age. The youngest age group (<6 months) showed an inverse summer=autumn to winter=spring ratio (>1.0) in KD-occurrence. CAAs were observed in 2.8% of cases (males = 3.4%, females = 2.1%), which significantly lessened in summer than in other seasons. Moreover, 50% (n = 4=8) of cases with giant aneurysms experienced KD in autumn. Adjusted ORs for CAAs among males aged ≥60 months (3.0; 95%, CI 1.2-7.5) and females aged <6 months (3.6; 95%, CI 1.1-11.8) were significantly higher than those among males aged 12-35 months. Conclusions: Cumulative 18-year data of consecutive KD cases from one area suggest the influence of interactions between patient age and sex on the development of KD-related CAAs. The season of KD-occurrence may reflect the diversity of agents.

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Epidemiologic features of Kawasaki disease distinguished by seasonal variation: an age-specific analysis

Cited by 16 publications

References 15 publications

Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015–2016

Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015–2016

Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic

Seasonal Variation in Epidemiology of Kawasaki Disease-Related Coronary Artery Abnormalities in Japan, 1999–2017

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