Kawasaki disease
Key facts
- Kawasaki disease starts with a high fever that lasts for several days.
- If your child has Kawasaki disease, they will need treatment in hospital.
- Early treatment is essential to prevent heart complications.
- Most children with Kawasaki disease recover completely.
- There is no clear link between Kawasaki disease and COVID-19 infection.
What is Kawasaki disease?
Kawasaki disease is a rare illness that mostly affects children under 5 years of age. The exact cause is unknown, but it involve swelling of the blood vessels, including those that lead to the heart. When blood vessels are inflamed, it is called vasculitis. Kawasaki disease is a collection of symptoms caused by vasculitis.
What are the symptoms of Kawasaki disease?
If your child has Kawasaki disease, their symptoms may include:
- a fever that lasts for at least 5 days
- a rash on the trunk, limbs and around the nappy area
- red, bloodshot eyes without discharge
- red, swollen, cracked lips
- a strawberry-like red tongue
- swollen hands and feet, with red palms and soles
- swollen glands in the neck
- joint pain
Your child may also be very uncomfortable, irritable and will usually look unwell. There are many conditions that have similar symptoms. Your doctor will exclude these before diagnosing Kawasaki disease.
A condition called Paediatric Multisystem Inflammatory Syndrome (PIMS) has many similar symptoms to Kawasaki disease, such as, fever, rash, red eyes, lips and mouth and swollen neck glands. PIMS is a rare complication of coronavirus COVID 19 infection and affects children. The condition appears as a new illness 2 to 6 weeks after infection with COVID 19. If your child develops any of these symptoms after having COVID 19, see your doctor immediately.
What causes Kawasaki disease?
Doctors don’t yet know the exact cause of Kawasaki disease. It is thought to be caused by an abnormal response of your child’s immune system to a common infection. Kawasaki disease is not contagious.
Kawasaki is also more common in people with North Asian ethnicity and is more common in males than females.
When should I see my doctor?
Contact your doctor if your child is showing signs of Kawasaki disease or has had fever for more than 2 days. Your doctor might refer your child to a paediatrician or hospital emergency department.
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How is Kawasaki disease diagnosed?
Kawasaki disease is difficult to diagnose because there is no single test to identify it. A doctor will review the signs and symptoms of the disease, in a child that has had ongoing fever, with no other likely explanation. Other investigations including blood tests, or an echocardiogram (heart ultrasound) may be performed to try to determine the likelihood of diagnosing Kawasaki disease.
How is Kawasaki disease treated?
If your child is diagnosed with Kawasaki disease, they will be treated in hospital with medicines called immunoglobulins — these have been proven to help prevent heart problems. Your child may also be given a low dose of aspirin, to help reduce the inflammation.
Most likely, your child will feel better the next day. On rare occasions, the fever may persist or come back, which may mean they need more treatment.
Your child’s doctor may recommend they continue aspirin treatment for up to 2 months after they leave hospital. They will also most likely need long-term follow up by a paediatric cardiologist (a children’s heart doctor), just to be sure they are recovering well.
You should delay your child’s MMR (measles, mumps, rubella) and varicella (chickenpox) immunisations until 11 months after the immunoglobulin treatment.
Can Kawasaki disease be prevented?
Kawasaki disease cannot be prevented. The risk of heart complications due to Kawasaki disease can be reduced with early diagnosis and treatment.
Complications of Kawasaki disease
The most serious complication of Kawasaki disease is inflammation of the arteries that provide the blood supply to the heart (the coronary arteries). This can cause an abnormal swelling of the artery wall, known as an aneurysm, which can cause heart problems in the future. This occurs in about 1 in 4 children if they do not receive treatment.
Your child will need to have a follow-up echocardiogram (ultrasound of the heart) around 6 weeks after they go home from hospital. This is to make sure that no further damage has occurred to the coronary arteries. If this test is normal, the doctor will most likely ask you to stop giving your child aspirin. If damage has occurred to your child’s coronary arteries, they will need ongoing care by a paediatric cardiologist (heart doctor).
Resources and support
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Last reviewed: July 2023
