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Kawasaki Disease

Wednesday, 28 January 2009

The death of a child is every parent's nightmare; and the recent death of actor John Travolta's 16 year old son Jett shocked every Irish parent; however, for mum and dad Damian and Louise Tobin, the shock must have been greater - their toddler son Aidan suffers from the same rare illness that is reported to have claimed the life of the tragic teen - that illness is the little known and rare condition, Kawasaki Disease.

What is Kawasaki Disease?
. It's an illness that affects the mouth, the skin and the lymph nodes. The disease got its name from the doctor who first described the illness in medical literature in 1967 - Japanese pediatrician, Doctor Tomisaku Kawasaki.
. It usually affects children under the age of 5 years, and usually boys, (over 4,000 cases of the disease are diagnosed annually in the US).
. Less than 1 per cent of those who suffering from it dies.
. If symptoms are recognised early, a full recovery is usually achieved within a few days. However, untreated, serious complications such as heart trouble can occur.
. This disease normally occurs in 19 out of every 1000,000 children in the USA but it is more common in children of Japanese and Korean descent; however it can affect all ethnic groups.
. Evidence suggests the disease is caused by an infectious agent like a virus. It's rare that more than one child in a family will develop it and less than 2 per cent of children have a further attack of the disease.

What are the symptoms of Kawasaki Disease?

Two Phases:
Symptoms can appear in phases so it is difficult to notice; but there is a persistent fever that lasts for at least 5 days. This fever is usually above 104 degrees. This would be known as Phase 1.

Other symptoms are severe redness in the eyes, (bloodshot eyes), a rash on the stomach, genitals and chest, dry, cracked lips, swollen, white coated tongue, sore throat, swollen palms, swollen feet with a purple, red colour and swollen lymph nodes. This is usually known as Phase 2.
Phase 2 occurs about two weeks after the fever phase - Phase 1, and then the skin on the hands and feet can peel. The child may have pains in his joints with diarrhea, vomiting and pains in the stomach.

How is it diagnosed?
There is no specific test to diagnose Kawasaki Disease and doctors usually evaluate the symptoms and rule out other conditions. If Kawasaki is suspected tests to monitor heart functions and urine samples may be taken to rule out other conditions like scarlet fever, measles, juvenile rheumatoid arthritis or possibly an allergic reaction.

Is Kawasaki Contagious?
It's believed a virus may be responsible for bringing on this disease but scientists believe it is not contagious and it does not appear to be hereditary. It was also thought it may be linked to rug or carpet cleaning materials but no links have been made.

What happens then?
If caught early, symptoms can disappear within two days of treatment. If treated within 10 days of the onset of symptoms it is usually possible that heart problems may not develop. If symptoms go untreated, more serious complications like an inflammation of blood vessels may occur. In addition to this, the hear muscle, lining and valves and outer membranes surrounding the heart can become inflamed. However, usually heart problems disappear within 5 to 6 weeks and there is no lasting damage.

Treatment?
As soon as possible, intravenous doses of gamma globulin (purified antibodies) which is an ingredient in blood, is given, this helps the body fight infections. A high dosage of aspirin to help reduce the risk of heart problems may also be given to the child.

So, why is this disease a cause for concern?
The symptoms usually run their course over a few weeks but the main concern would be the heart and blood vessel trouble it can cause. The coronary arteries provide the heart muscle with an oxygen rich blood supply and Kawasaki disease can weaken the wall of one or even more of these arteries and this can cause it to bulge or balloon out. This weakened bugled out area is called an aneurysm. If blood clots in this bulged out area (aneurysm) it can possibly block the blood flow through the coronary artery; if this happens, the heart muscle will no longer receive an adequate supply of oxygen rich blood and the heart muscle can be damaged. On rare occasions the aneurysm can burst.

Also, further damage to the heart can develop as your child's body attempts to heal itself. Complications can include damage to the heart muscle; stenosis, where a blood vessel becomes narrowed restricting blood flow and this may cause a heart attack. Occasionally, neurological complications can occur including facial nerve palsy and fits (seizures).

So, what's the long term outlook following a bout of this disease?It's thought about 80 per cent of children make a full recovery. However, if an aneurysm is detected, echo cardiograms will be repeated regularly and sometimes for several years after the illness as some heart problems may not be evident straight away. Preventive measures are advised, such as healthy eating and living habits, and always follow up on your doctor's visits.

Can Kawasaki Disease be prevented?
Short answer is No. Scientists have found no known way of preventing this disease.

What should I do if I suspect my child has Kawasaki Disease?
If you suspect your child has Kawasaki, seek your doctor's advice immediately. It is crucial to prevent long term health damage. If your child has a prolonged temperature for a few days (5 or more) and at least two of the symptoms listed here, see your doctor immediately.

Source: http://www.healthsystem.virginia.edu/uvahealth/peds_arthritis/kawasaki.cfm
http://hcd2.bupa.co.uk/fact_sheets/html/kawasaki_disease.html Publication date: August 2008.

Please note that the advice contained is intended as general information only and is NOT meant to replace professional, expert advice from a healthcare professional or doctor.

For more information on Kawasaki Disease.
. For more info, log on to www.kdfoundation.org
. Kawasaki Support Group 0044 24 7661 2178

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