Kawasaki disease Q&As
Published by Bupa's health information team, January 2009.
Answers to questions about Kawasaki disease
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- What should I do if I think my child has Kawasaki disease?
- Will Kawasaki disease have any long-term health effects on my child?
- How can I prevent my child from getting Kawasaki disease?
- Isn't it dangerous to give children under the age of 16 aspirin? Why is it given to children to treat Kawasaki disease?
What should I do if I think my child has Kawasaki disease?
Kawasaki disease can cause long-term health problems for your child or may even be fatal, so getting treatment quickly is vital. If you suspect your child has the disease, you should make an urgent appointment to see your GP or take your child to the nearest accident and emergency department at the hospital.
Explanation
Most children with Kawasaki disease who have received prompt treatment go on to make a full recovery. However, because of the complications associated with the disease, some children suffer long-term health conditions, or may even die.
In the UK just under four percent of children with Kawasaki disease die, but this isn't from the disease. Rather it's a result of inflammation to the coronary arteries which causes damage to the heart, such as an aneurysm. Treatment aims to reduce the inflammation in your child's body, especially the heart, as quickly as possible. If caught early enough, within ten days, this can be done using a combination of aspirin and immunoglobulin. The effectiveness of immunoglobulin after ten days is not clear, but it's still given.
The UK has relatively few cases of Kawasaki disease compared to countries like Japan, where 30 times more children are affected. However, the UK has one of the highest numbers of deaths from the disease, just over four percent, whereas in Japan the mortality rate is much lower, less than one percent. It's not clear if this is because the condition is more severe in the UK, or because diagnosing and treating the condition takes longer than in other countries, such as Japan.
If you suspect your child has Kawasaki disease, seeking out treatment from your GP or other healthcare providers immediately is crucial to prevent long-term health damage. If your child has had a high temperature for longer than five days and has two or more of the main symptoms of the disease, make an urgent appointment to see your doctor.
Further information
- Kawasaki Support Group
024 7661 2178
Sources
- Baumer J, Love S, Gupta A, et al. Salicylate for the treatment of Kawasaki disease in children. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004175. DOI: 10.1002/14651858.CD004175.pub2
- Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2007
Will Kawasaki disease have any long-term health effects on my child?
Most children make a full recovery from Kawasaki disease. However, some, especially those who suffer damage to their heart, may need regular monitoring indefinitely to treat conditions that develop as a complication of the disease.
Explanation
Kawasaki disease is the most common cause of acquired heart disease in children in the UK. If your child has developed heart disease, he or she may need regular long-term monitoring, treatment and lifestyle changes to prevent their coronary arteries from becoming blocked or having a heart attack. How much will depend on how serious the damage to their heart is. In severe cases, your child may not be able to take strenuous exercise and may need to have a special kind of echocardiogram called a dobutamine stress echocardiogram to see how much activity is possible for them. A dobutamine stress echocardiogram allows the heart to be examined during rest and under stress.
It has been found that children who have had Kawasaki disease are more likely to develop coronary atherosclerosis as adults. This is when fat and cholesterol in the blood build up on an artery wall, forming a plaque or atheroma. The plaque can prevent the heart muscle from getting the blood supply (and therefore oxygen) it needs. This can cause chest pain (angina) when doing physical exertion or under emotional stress. It has been recommended that all children who have had Kawasaki disease have annual life-long check-ups to measure their blood pressure and look for other possible signs of heart disease.
Some children may have symptoms of Kawasaki disease that keep coming back long after they have recovered from their initial bout. These can include eczema, mild peeling of their skin on their fingers, an irritable bowel or, even, a complete return of the disease.
If you have any concerns about your child's long-term health after Kawasaki disease or any persistent symptoms, you should talk to your GP or your child's paediatrician.
Further information
- Kawasaki Support Group
024 7661 2178
Sources
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007
- Wood LE, Tulloh RMR. Diagnosis and management of Kawasaki disease in children. Paediatrics and Child Health. 2008; 18(2):70-74
How can I prevent my child from getting Kawasaki disease?
The exact cause of Kawasaki disease is not known at present, so there is currently no means by which to protect your child from getting it. However, being vigilant and picking up on symptoms of the disease early could help prevent long-term damage to your child's health.
Explanation
Preventing your child from getting Kawasaki disease is not possible at the moment. This is because the causes of the disease, which inflames your child's blood vessels, are not understood. It has been suggested that it may be due to an infection which some children are more susceptible to than others.
The best way to help your child is to be alert to any changes in their health and to know the symptoms to look out for. The most common symptoms of Kawasaki disease are:
- fever (high temperature) lasting longer than five days
- conjunctivitis (an inflammation of the transparent layer that covers the white of the eye) affecting both eyes
- blotchy, red rash mainly on the trunk of the body
- changes to the lips or mouth including reddened, dry or cracked lips, and a strawberry-coloured, inflamed tongue
- sore throat
- hands and feet become swollen, red and hard, especially the palms and soles, resulting in peeling skin on the fingertips and toes
- peeling and shedding skin around the groin
- swollen lymph glands, you may feel swollen lumps either side of your child's neck
Another common symptom is for your child to be irritable or behave unreasonably, in a way they would not normally. Other possible symptoms include a runny nose, cough, sore tummy, vomiting, diarrhoea, yellowing skin (jaundice) and painful or swollen joints.
Many of the symptoms of Kawasaki disease can be easily confused with symptoms of other childhood disease such as measles, so it can be difficult to spot. However, if you think your child has the disease, especially if they have had a high temperature for five days or more, you should make an emergency appointment with your GP. A complication of Kawasaki disease is long-term heart damage, so immediate treatment is crucial to prevent this from happening.
Further information
- Kawasaki Support Group
024 7661 2178
Sources
- Wood LE, Tulloh RMR. Diagnosis and management of Kawasaki disease in children. Paediatrics and Child Health, 2008; 18(2):70-74
- National Institute for Clinical Excellence (NICE), Assessment and initial management in children younger than 5 years. May 2007. www.nice.org.uk
- Kawasaki Disease. eMedicine. www.emedicine.com, accessed 27 May 2008
- Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2007
Isn't it dangerous to give children under the age of 16 aspirin? Why is it given to children to treat Kawasaki disease?
It's unsafe for children under the age of 16 to take aspirin as it can cause Reye's syndrome. However, for those with Kawasaki disease, the benefits of taking aspirin to treat potentially fatal complications of the disease outweigh the risks.
Explanation
Reye's syndrome is a rare disease that mainly affects children and teenagers. It affects all the organs in the body, but can be especially harmful to the brain and liver. The condition must be treated immediately, otherwise it can be fatal. Approximately 30-40 percent of those with the condition die. It's exact causes are unclear, but it has been linked to giving aspirin to children who have a fever. This has led to government-backed advice that aspirin should not be given to children under the age of 16.
However, aspirin is an important treatment for Kawasaki disease. This is because it's very good at reducing inflammation in the body quickly, and it helps prevent blood clots forming that could cause long-term damage to the heart. Initially your child will be given high doses of aspirin at regular intervals. Once their fever has settled, the dose of aspirin can be reduced. He or she will then need to continue taking it for a minimum of a further six weeks.
Kawasaki disease is a life-threatening condition that can cause serious long-term damage to the heart. Doctors believe that the benefits of taking aspirin for a relatively short period of time to prevent this type of damage outweigh the risks of Reye's disease. There are only very few situations in which aspirin should be given to children, and these should always be under medical supervision.
If you have any questions or concerns about giving aspirin to your child, talk to your GP immediately.
Further information
- Kawasaki Support Group
024 7661 2178
Sources
- Aspirin (in Reye's syndrome). GP Notebook. www.gpnotebook.co.uk, accessed 17 July 2008
- Joint Formulary Committee, British National Formulary for children. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2007
Related topics
- Kawasaki disease
- Angina
- Conjunctivitis
- Echocardiogram
- Eczema
- Fever in children
- Irritable bowel syndrome
- Measles
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Colin Melville MB, ChB, MMed Ed, FRCPCH Consultant Paediatrician, Mid Staffordshire, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: January 2009
Kawasaki disease factsheet
Visit the Kawasaki disease health factsheet for more information.
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