Epidemiologic features of Kawasaki disease in Taiwan, 1996-2002.
OBJECTIVE
Kawasaki disease (KD) is the most common acquired heart disease in children worldwide. The incidence of KD varies among different countries, with Asian countries supposedly having higher incidences than Western countries. However, the incidence of KD in Taiwan has not been well investigated.


METHODS
Since the implementation of Taiwan's National Health Insurance (NHI) in 1995, NHI has covered health care for >96% its population. Using the NHI database from 1996 to 2002, we investigated epidemiologic features of KD (International Classification of Diseases, Ninth Revision, code 446.1), the rate of coronary artery aneurysm formation (International Classification of Diseases, Ninth Revision, code 414.11), and the change in incidence during the recent 7 years. We also compared the annual incidences in Taiwan with those reported by other countries.


RESULTS
During the 7-year study period, KD occurred most frequently in the summer and least frequently in winter. It is interesting that the highest peak occurred in the summer of 1998 at the same time that Taiwan's enterovirus 71 epidemic was occurring. Ninety-one percent of KD cases occurred in children who were <5 years old, and the male-to-female ratio was 1.70:1. Recurrence of KD was found in 1.3% (94 of 7305) of these children, and coronary artery aneurysm was found in 7.3% (536 of 7305). The annual incidence per 100,000 children was 146 in children <1 year old, 98 in 1-year-old children, 51 in 2-year-old children, 28 in 3-year-old children, 19 in 4-year-old children, and 5.3 in 5- to 9-year-old children; the incidence of KD decreased with increased age. The overall incidence was 66 cases per 100,000 children <5 years old from 1996 to 2002 with the annual incidence not differing significantly during the 7-year study period.


CONCLUSIONS
KD in Taiwan occurs more frequently in boys and in the summer months. During the 7-year study period, the annual KD incidence in Taiwan of 66/100000 in children <5 years old was the second highest in the world after Japan.
Chang
Luan-Yin
LY
Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chang
I-Shou
IS
Lu
Chun-Yi
CY
Chiang
Bor-Luen
BL
Lee
Chin-Yun
CY
Chen
Pei-Jer
PJ
Wang
Jin-Town
JT
Ho
Hong-Nerng
HN
Chen
Ding-Shinn
DS
Huang
Li-Min
LM
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000453:epidemiology / Q000209:etiology; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D012621:Seasons; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology