What is the international incidence of Kawasaki disease?

Updated: Jul 29, 2018
  • Author: Tina K Sosa, MD; Chief Editor: Russell W Steele, MD  more...
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KD is most frequently observed in Japan, Taiwan, and Korea. The highest incidence of KD has been reported in Japan, where the frequency of the disease is 10 to 20 times higher than in western countries. [33]   Although the birth rate has declined, the numbers of patients diagnosed as having KD and the incidence rate in Japan have risen rapidly since the 1990s. The incidence in 2000 was 134.2 cases per 100,000 children younger than 5 years; in 2012, the incidence was 264.8 per 100,000 children younger than 5 years. [38]  Epidemics occurred in Japan during the years 1979, 1982, and 1986. No epidemics have occurred since that time. Marked spatial and temporal patterns have been noted in both the seasonality and deviations from the average number of KD cases in Japan. Seasonality is bimodal, with peaks in January and June and/or July and a nadir in October. This pattern was consistent throughout Japan during an entire 14-year period which was studied. Very high or low numbers of cases were reported in certain years, but the overall variability was consistent throughout the entire country. Temporal clustering of KD cases was detected with nationwide outbreaks. [39]

Park et al noted the average annual rate of incidence of KD in South Korea was 105 cases per 100,000 in children younger than 5 years, which was the second highest reported rate in the world. [40] On average, the approximate annual incidence of KD in various Asian populations per 100,000 children younger than 5 years is 54.9 cases for Taiwan, 25.4 cases for Hong Kong, 16.8-36.8 cases for Shanghai, and 18.2-30.6 cases for Beijing.

The annual incidence reported in white populations outside the United States is similar to that reported in the US population, with 11.3-14.7 cases per 100,000 children younger than 5 years in Canada and 3.6 cases per 100,000 children younger than 5 years in Australia. [41, 42] From 1999-2000, the incidence in the United Kingdom was 8.1 cases per 100,000 children. [43]

Ontario has the highest rate of KD outside of Asia, with a yearly incidence of 26.2 cases per 100,000 population younger than 5 years. The incidence significantly increased from 1995 to 2006, with more patients diagnosed with incomplete KD. A reduction in coronary abnormalities was also seen during this period and was attributed to better recognition and treatment of the disease. [44]

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