Is Kawasaki Disease Caused by Covid-19 in Young Children?
In the news lately there have been reports of a “mysterious new pediatric condition” affecting young children in Europe and New York that may be COVID-related. These reports are claiming this “new” illness is mimicking a decades-old pediatric condition called Kawasaki disease.
As with many news reports related to the coronavirus, the tone of such reporting seems to flip-flop between a calm warning to outright panic. For many of us parents, we just want to know the facts and whether this new development should be a cause for public concern. And usually, if you dig down deep into the truth of the matter in things like this, there seems to be a comfortable medium ground: reasonable concern but no need for panic.
The same can be said about this issue. While parents should be made aware of the signs and symptoms of Kawasaki disease, there is no evidence that it is directly related to the recent Covid-19 outbreak. Here is what you need to know.
What is Kawasaki Disease?
Kawasaki disease is an unusual illness characterized by inflammation of blood vessels throughout the body. Kawasaki disease affects children almost exclusively. Most patients are under 5 years of age but have been seen in patients in their mid- to late-teens. Males acquire the illness almost twice as often as females, for reasons as yet unknown.
Kawasaki disease was discovered in 1967 by Japanese pediatrician, Tomisaku Kawasaki. In the United States, the disease has been reported in all racial and ethnic groups. But it is most often found in children of Asian-American descent. Kawasaki disease can occur in clusters or localized outbreaks – usually in the winter and spring.
While many of the news articles reporting on Kawasaki disease state that it is a “rare” disease, it is more common than is let on. The exact number of cases that occur each year in the United States has not been determined. However, it is estimated that there are between 4,000-5,000 diagnosed cases of Kawasaki disease each year in the U.S. The disease attacks 15-20 out of every 100,000 children less than 5 years of age.
What causes Kawasaki disease?
While there is no known cause for the disease, most doctors agree that there are some inherited genes that make a child more likely to develop Kawasaki. Typically, an infectious illness, such as a virus or bacteria, is the triggering event for a child who is predisposed to develop Kawasaki disease. There is no evidence that the disease is contagious.
How is Kawasaki disease treated?
Typically, a high dose of intravenous gamma globulin (IVIG, a protein fraction of human blood) is the preferred treatment for patients with Kawasaki disease. IVIG treatment is believed to be most effective in reducing inflammation and preventing coronary artery damage if it is started within the first 10 days of illness.
Also, high doses of aspirin are given during the acute phase of the illness until the fever subsides. Children being treated will also need to be monitored for more serious complications of the disease, such as aneurysms and other heart or blood vessel abnormalities.
Is this disease related to Covid-19?
Not necessarily. Since infectious illnesses seem to trigger Kawasaki disease in children who are predisposed to it, there is certainly a chance that a child who contracted Covid-19 may later develop Kawasaki. However, we do not know if a predisposed child who has contracted COVID-19 is more likely to have an onset of the disease than if they’ve been infected by any other virus or bacteria.
So far, in New York, 15 children have been reported as having the symptoms of Kawasaki disease. Of these reports, only 4 of those children have been identified as having also been diagnosed with Covid-19. As for the cases being reported out of the U.K., so far there have been a total of about 20 cases, only half of which have been reported as having also been diagnosed with Covid-19.
In fact, the Societi Foundation, the UK’s Kawasaki disease foundation, responded to the media reports on April 28, 2020. They stated that “here is no current evidence of any increased incidence or greater susceptibility to Covid-19 infection for children who had Kawasaki Disease in the past.” Further, “ewer cases of Kawasaki Disease than would be normally expected at this time of year are currently being seen – not more.”
What symptoms should you look out for?
Kawasaki disease symptoms usually present in three phases.
Phase 1 symptoms may include:
- A fever that is often is higher than 102.2 F (39 C) and lasts more than three days
- Extremely red eyes without a thick discharge
- A rash on the main part of the body and in the genital area
- Red, dry, cracked lips and an extremely red, swollen tongue
- Swollen, red skin on the palms of the hands and the soles of the feet
- Swollen lymph nodes in the neck and perhaps elsewhere
Phase 2 symptoms may include:
- Peeling of the skin on the hands and feet, especially the tips of the fingers and toes, often in large sheets
- Joint pain
- Abdominal pain
In Phase 3, symptoms of Kawasaki disease generally go away, unless complications develop. However, it may be several weeks until energy levels seem to normalize.
With effective treatment, very few children have lasting effects. However, left untreated, Kawasaki disease may result in the following heart complications:
- Inflammation of blood vessels, usually the coronary arteries, that supply blood to the heart
- Inflammation of the heart muscle
- Heart valve problems
Is there a reason to panic?
Absolutely not. The bottom line, as far as anyone knows right now, is that no child is any more or less likely to develop Kawasaki disease due to Covid-19 than they were before Covid-19 came along. That does not change the fact that, as a parent, you should absolutely be diligent in monitoring your child’s health for the signs and symptoms of any illness, including Kawasaki disease.
If you believe your child is exhibiting symptoms of Kawasaki or Covid-19, you should call your child’s pediatrician immediately. Otherwise, try not to let fear and panic control your emotions in this already highly stressful time. Take care of your kids, take care of yourself, remain diligent and attentive to everyone’s health. And above all, keep calm and mom on!