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U.S. rates of Kawasaki syndrome are highest in Japanese American children living in Hawaii

Kawasaki syndrome (KS), which primarily strikes children under the age of 5, can cause serious heart disease due to inflammation of the blood vessels in the coronary arteries. KS, whose cause is not known, was first described among Japanese children in 1967. The disease currently affects Japanese American children who live in Hawaii more than any other children in the United States and even more than children living in Japan. This may indicate the influence of environmental risk factors, as opposed to a purely genetic predisposition in the etiology of the disease, explains Robert Holman, M.S., of the Centers for Disease Control and Prevention, along with his co-author, Claudia A. Steiner, M.D., M.P.H., of the Agency for Healthcare Research and Quality.

The researchers analyzed the State Inpatient Database for Hawaii residents hospitalized with KS during 1996 through 2001. During that period, 267 individuals younger than 18 years living in Hawaii were hospitalized for KS; 85 percent of those affected were younger than 5 years. The average annual incidence of KS was 45.2 per 100,000 children younger than 5 years. The incidence was higher for children younger than 1 year than for those 1-4 years (74.3 vs. 37.5 per 100,0000). The KS incidence for Asian and Pacific Islander children and for white children was 70.9 and 35.3 per 100,000 respectively.

Incidence was highest among Japanese American children living in Hawaii (197.7 per 100,000). The mean hospital stay for children with KS younger than 5 years was 2 days, and the median hospital charge was $9,379. Given the high incidence of KS among young children and infants in Hawaii, monitoring of KS and its effect on these children is important, suggest the researchers.

More details are in "Kawasaki syndrome in Hawaii," by Robert C. Holman, M.S., Aaron T. Curns, M.P.H., Ermias D. Belay, M.D., and others, in the May 2005 the Pediatric Infectious Disease Journal 24(5), pp. 429-433. Reprints (AHRQ Publication No. 05-R073) are available from the AHRQ Publications Clearinghouse.

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