title: Repeated systematic surveillance of Kawasaki disease in Ontario from 1995 to 2006.
abstract: BACKGROUND
  Rising incidences of Kawasaki disease (KD) have been reported worldwide. Reported herein are the results of 4 triennial KD surveillances conducted in Ontario.
  
  
  METHODS
  Between 1995 and 2006 all hospitals in Ontario were asked on 4 occasions to identify all patients with discharge diagnoses of KD and report incident cases.
  
  
  RESULTS
  The latest surveillance identified 697 new KD patients (100% response rate) for a total of 2378 KD patients through all 4 surveillances. Yearly incidence was 26.2/100,000 for <5 years old, 6.7/100,000 for 5-9 years old and 0.9/100,000 for 10-14 years old. KD incidence significantly increased from 1995 to 2006, although the increase seemed to plateau between the 3rd and 4th surveillance. There was an increase in the proportion of patients diagnosed with incomplete KD and a significant reduction in the rate of coronary artery abnormalities, possibly due to better disease recognition and treatment. Hospitals reporting <20 cases per surveillance were found to be more likely to report cases with incomplete KD. These patients were also less likely to be treated with i.v. immunoglobulin and aspirin but were more likely to be treated with antibiotics, suggesting uncertainties regarding diagnosis and management of KD patients in those centers.
  
  
  CONCLUSIONS
  The incidence of KD in Ontario is possibly one of the highest outside of Asia and has been rising since 1995. Although the most recent surveillance demonstrated improved cardiac outcomes, treatment delays or absence thereof continue to be a problem. Effective diagnosis and prompt treatment remain critical aspects of KD management.
authors.affiliation: Labatt Family Heart Centre, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Yahui T
authors.initials: YT
authors.lastname: Lin
authors.forename: Cedric
authors.initials: C
authors.lastname: Manlhiot
authors.forename: Joyce C Y
authors.initials: JC
authors.lastname: Ching
authors.forename: Ra K
authors.initials: RK
authors.lastname: Han
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Nield
authors.forename: Rejane
authors.initials: R
authors.lastname: Dillenburg
authors.forename: Dion
authors.initials: D
authors.lastname: Pepelassis
authors.forename: Lillian S
authors.initials: LS
authors.lastname: Lai
authors.forename: John F
authors.initials: JF
authors.lastname: Smythe
authors.forename: Nita
authors.initials: N
authors.lastname: Chahal
authors.forename: Rae S M
authors.initials: RS
authors.lastname: Yeung
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D038801:International Classification of Diseases; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D018570:Risk Assessment; D012621:Seasons; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D055815:Young Adult