Kawasaki disease
Key facts
- Kawasaki disease starts with a high fever that lasts several days.
- Your child will need care from a GP and paediatrician if they have the disease.
- Early treatment is essential.
- Most children with Kawasaki disease recover completely.
- There is no clear association between Kawasaki disease and COVID-19 infection.
What is Kawasaki disease?
Kawasaki disease is a condition that causes inflammation (swelling) of the blood vessels, including those that lead to the heart. Doctors consider it to be a type of vasculitis. The condition is named after the Japanese doctor who first identified it in 1967.
Kawasaki disease is rare, with fewer than 300 cases per year across Australia. It tends to affect children under 5 years of age, and occurs more rarely in older children, teenagers and adults.
What are the symptoms of Kawasaki disease?
Early symptoms of Kawasaki disease include:
- a fever that lasts for several days
- a rash — especially in the groin (nappy) area
- red, bloodshot eyes
- red, swollen, cracked lips
- a strawberry-like red tongue
- swollen hands and feet, with red palms and soles
- swollen glands in the neck
Children with these symptoms will be very uncomfortable and irritable. There are many conditions that have similar symptoms, and your doctor will exclude these before diagnosing Kawasaki disease.
What causes Kawasaki disease?
Doctors don’t yet know the exact cause of Kawasaki disease, but research shows it may be a response to infection. Antibiotics are not needed to treat Kawasaki disease.
Asian people, particularly Japanese boys, are more likely to be affected, which suggests this may be for genetic reasons. However, Kawasaki disease is not contagious and the brothers and sisters of an affected child usually do not catch it.
Is Kawasaki disease caused by COVID-19?
There have been reports from Europe and North America that a very small number of children have become ill with initial symptoms similar to those of Kawasaki disease. The condition that presents with these symptoms, however, is known as multisystem inflammatory syndrome (MIS). Some of these children tested positive for COVID-19.
COVID-19 may be a trigger for MIS. At this very early stage, the link is not yet clear and further research is being done.
If your child is sick — with a fever, sore throat, rash or diarrhoea (or any of the symptoms mentioned above) — keep them home from school and to seek medical attention from your GP.
If you have questions about COVID-19, call the Australian Government's National Coronavirus Helpline on 1800 020 080.
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 the local hospital emergency department.
How is Kawasaki disease diagnosed?
There is no single test for Kawasaki disease. A doctor will review the symptoms and signs of the disease in a child who has ongoing fever with no other likely explanation. While blood tests, an ECG (heart tracing) or an echocardiogram (heart ultrasound) may be helpful, there is no diagnostic test, and this makes Kawasaki disease difficult to diagnose.
How is Kawasaki disease treated?
A child diagnosed with Kawasaki disease will be treated in hospital, usually with immunoglobulin (gammaglobulin) given to them through a drip into the vein over several hours. Often, the child feels better the next day. They may also be given aspirin to help reduce the inflammation. On rare occasions, the fever may persist or come back and then require additional treatment.
Aspirin treatment may be continued for 2 months after the child leaves hospital, and long-term follow up by a cardiologist may be recommended as a precaution.
You should delay your child’s routine immunisations, such as MMR (measles, mumps, rubella) or varicella (chickenpox), until 11 months after the immunoglobulin treatment.
Are there complications of Kawasaki disease?
A prompt diagnosis and treatment are important to prevent complications of Kawasaki disease.
Most children will recover fully within 4 to 8 weeks, but because Kawasaki disease causes inflammation of the coronary (heart) arteries, a minority of children will have heart problems that will require ongoing monitoring, and some will need longer-term treatment. Children who do not have heart problems with Kawasaki disease will not need any long-term follow up.
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Last reviewed: May 2020
