Abstract
The aim of this study was to estimate incidence of Kawasaki disease (KD) in Chandigarh, North India, during 2009–2014. Diagnosis of KD was based on American Heart Association guidelines. Records of all children diagnosed with KD below 15 years at a large tertiary care referral centre from North India for paediatric immunology were analysed from January 2009 to December 2014. Children residing in Chandigarh were identified. Incidence rates were calculated based on population of Chandigarh in National Census 2011. Methodology was similar to our previously reported study from 1994 to 2008. Incidence of KD in children below 5 was also computed. A total of 258 children were diagnosed to have KD. Of these, 54 (43 boys, 11 girls) resided in Chandigarh. Coronary artery abnormalities on echocardiography were noted in 6. Incidence rate varied between 1.11 (in 2012) and 4.71/100,000 children below 15 (in 2009). In children below 5, incidence rate varied between 1.0 (in 2012) and 9.1/100,000 (in 2009). Peak incidence of KD was in third year of life. There was clustering of cases in February, April, June and October with a nadir in July. While the overall number of KD cases has increased, the 2009–2014 Chandigarh incidence is comparable to our previous figures. Our study is based on hospitalized children with KD and may be missing patients diagnosed elsewhere but that number is likely to be small. Further, patients in whom the diagnosis has never been made would also be missed. Median age at diagnosis has reduced as compared to our previous study. This is probably a reflection of increased awareness about KD amongst paediatricians and physicians in the region as a result of which the proportion of infants and young children diagnosed to have KD has shown a significant increase. Seasonal pattern of occurrence of KD is consistent with our previous observation.
Similar content being viewed by others
References
Singh S, Aulakh R, Bhalla AK et al (2011) Is Kawasaki disease incidence rising in Chandigarh, North India? Arch Dis Child 96:137–140
Makino N, Nakamura Y, Yashiro M et al (2015) Descriptive epidemiology of Kawasaki disease in Japan, 2011–2012: from the results of the 22nd nationwide survey. J Epidemiol 25(3):239–245
Kim GB, Han JW, Park YW et al (2014) Epidemiologic features of Kawasaki disease in South Korea: data from nationwide survey, 2009–2011. Pediatr Infect Dis J 33(1):24–27
Huang WC, Huang LM, Chang IS et al (2009) Kawasaki Disease Research Group. Epidemiologic features of Kawasaki disease in Taiwan, 2003–2006. Pediatrics 123(3):e401–e405
Singh S, Vignesh P, Burgner D (2015) The epidemiology of Kawasaki disease: a global update. Arch Dis Child 100(11):1084–1088
Uehara R, Belay ED (2012) Epidemiology of Kawasaki disease in Asia, Europe, and the United States. J Epidemiol 22:79–85
Sánchez-Manubens J, Antón J, Bou R, Iglesias E, Calzada-Hernandez J (2016) Incidence, epidemiology and clinical features of Kawasaki disease in Catalonia, Spain. Clin Exp Rheumatol 34(3 Suppl 97):139–144
Holman RC, Belay ED, Christensen KY, Folkema AM, Steiner CA, Schonberger LB (2010) Hospitalizations for Kawasaki syndrome among children in the United States, 1997–2007. Pediatr Infect Dis J 29(6):483–488
Tacke CE, Breunis WB, Pereira RR, Breur JM, Kuipers IM, Kuijpers TW (2014) Five years of Kawasaki disease in the Netherlands: a national surveillance study. Pediatr Infect Dis J 33(8):793–797
Du ZD, Zhang T, Liang L et al (2002) Epidemiologic picture of Kawasaki disease in Beijing from 1995 through 1999. Pediatr Infect Dis J 21:103–107
Du ZD, Zhao D, Du J et al (2007) Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004. Pediatr Infect Dis J 26:449–451
Ma XJ, Yu CY, Huang M et al (2010) Epidemiologic features of Kawasaki disease in Shanghai from 2003 through 2007. Chin Med J 123:2629–2634
Li XH, Li XJ, Li H et al (2008) Epidemiological study of Kawasaki disease in Sichuan province of China. J Trop Pediatr 52:133–136
Cheung YF (2012) Kawasaki disease in Hong Kong, 2000–2011. In: Proceedings of the tenth international Kawasaki disease symposium, 2012 Feb 7–10, Kyoto. Jpn Pediatr Int 54(Suppl 1):42–3
Chandigarh - Census 2011. www.census2011.co.in
Newburger JW, Takahashi M, Gerber MA et al (2004) Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110:2747–2771
Son MB, Sundel RP (2015) Kawasaki disease. In: Petty RE, Laxer RM, Lindsley CB, Wedderburn LR (eds) Textbook of pediatric rheumatology, 7th edn. Elsevier, Philadelphia, pp 467–483
Fischer TK, Holman RC, Yorita KL, Belay ED, Melbye M, Koch A (2007) Kawasaki syndrome in Denmark. Pediatr Infect Dis J 26(5):411–415
Heuclin T, Dubos F, Hue V, Godart F, Francart C, Vincent P (2009) Increased detection rate of Kawasaki disease using new diagnostic algorithm, including early use of echocardiography. J Pediatr 155(5):695–699
Singh S, Bansal A, Gupta A et al (2005) Kawasaki disease: a decade of experience from North India. Int Heart J 46(4):679–689
Singh S, Gupta MK, Bansal A et al (2007) A comparison of the clinical profile of Kawasaki disease in children from Northern India above and below 5 years of age. Clin Exp Rheumatol 25:654–657
Singh S, Kawasaki T (2009) Kawasaki disease—an Indian perspective. Indian Pediatr 46:563–571
Burns JC, Herzog L, Fabri O, Tremoulet AH, Rodó X, Uehara R et al (2013) Kawasaki Disease Global Climate Consortium. Seasonality of Kawasaki disease: a global perspective. PLoS ONE 8(9):e74529
Kumar RK, Tandon R (2013) Rheumatic fever and rheumatic heart disease: the last 50 years. Indian J Med Res 137(4):643–658
Shah I, Prabhu SS (2009) Response of refractory Kawasaki disease to intravenous methylprednisolone. Ann Trop Pediatr 29(1):51–53
Thapa R, Chakrabartty S (2009) Atypical Kawasaki disease with remarkable paucity of signs and symptoms. Rheumatol Int 29(9):1095–1096
Suresh N, Sankar J (2010) Macrophage activation syndrome: a rare complication of incomplete Kawasaki disease. Ann Trop Pediatr 30(1):61–64
Agarwal A, Kamath N, Baliga S (2011) High sensitivity C reactive protein in classical Kawasaki disease. Indian Pediatr 48(4):330–331
Balasubramanian S, Krishna MR, Dhanalakshmi K et al (2012) Factors associated with delay in diagnosis of Kawasaki disease in India. Indian Pediatr 49(8):663–665
Mandal S, Pande A, Mandal D et al (2012) Various coronary artery complications of Kawasaki disease: series of 5 cases and review of literature. J Cardiovasc Dis Res 3(3):231–235
Sivakumar K, Pavithran S (2013) Extensive coronary aneurysms with thrombosis in resistant Kawasaki disease. Pediatr Cardiol 34(2):444–446
Shah B, Sharma M, Kumar R et al (2013) Rheumatic heart disease: progress and challenges in India. Indian J Pediatr 80(Suppl 1):77–86
Negi PC, Kanwar A, Chauhan R (2013) Epidemiological trends of rheumatic fever/rheumatic heart disease in school children of Shimla in North India. Indian J Med Res 137(6):1121–1127
Durongpisitkul K, Sangtawesin C, Khongphatthanayopthin A et al (2006) Epidemiologic study of Kawasaki disease and cases resistant to IVIG therapy in Thailand. Asian Pac J Allergy Immunol 24(1):27–32
Piao J, Jin L, Lv J et al (2010) Epidemiological investigation of Kawasaki disease in Jilin province of China from 2000 to 2008. Cardiol Young 20(4):426–432
Borzutzky A, Hoyos-Bachiloglu R, Cerda J et al (2012) Rising hospitalization rates of Kawasaki Disease in Chile between 2001 and 2007. Rheumatol Int 32(8):2491–2495
Acknowledgments
The authors wish to acknowledge the role of Dr. Jane C. Burns (mentorship); Dr. Anju Gupta and Dr. Deepti Suri (clinical management of patients); Dr. Amit Rawat (laboratory investigations); Dr. Manoj Kumar Rohit and Dr. Nidhi Narula (echocardiography).
Authors’ contribution
Dr. Surjit Singh planned the study, managed the patients, reviewed the manuscript and did the final editing. Dr. Sagar Bhattad collated the data, wrote the first draft and reviewed the literature.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None of the authors have any potential conflicts of interest.
Rights and permissions
About this article
Cite this article
Singh, S., Bhattad, S. Kawasaki disease incidence at Chandigarh, North India, during 2009–2014. Rheumatol Int 36, 1391–1397 (2016). https://doi.org/10.1007/s00296-016-3543-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-016-3543-y