Viral infections associated with Kawasaki disease.
OBJECTIVE
Kawasaki disease (KD) is a disease of unknown cause. To investigate the infectious etiology of Kawasaki disease, we initiated a prospective case-control study to investigate possible links between common viral infections and Kawasaki disease.


METHODS
We enrolled 226 children with KD and 226 age- and sex-matched healthy children from February 2004 to March 2010. Throat and nasopharyngeal swabs were taken for both viral isolation and polymerase chain reaction (PCR) for various viruses.


RESULTS
The mean age of the 226 KD cases was 2.07 years, and the male to female ratio was 1.43 (133 boys to 93 girls). Their mean fever duration was 7.5 days with a mean peak temperature of 39.7°C. In addition to the typical symptoms of fever, neck lymphadenopathy, lip fissure and/or strawberry tongue, skin rash, nonpurulent bulbar conjunctivitis, palm/sole erythema, and induration followed by periungual desquamation, these KD cases also exhibited cough (69%), rhinorrhea (58%), and diarrhea (45%). Cases of KD had a significantly higher positive rate of viral isolation in comparison with the control group (7.5% vs. 2.2%, p = 0.02). Compared with the control group, cases of KD were more likely to have overall positive rates of viral PCR (50.4% vs. 16.4%, p < 0.001) and for various viruses including enterovirus (16.8% vs. 4.4%, p < 0.001), adenovirus (8.0% vs. 1.8%, p = 0.007), human rhinovirus (26.5% vs. 9.7%, p < 0.001), and coronavirus (7.1% vs. 0.9%, p = 0.003).


CONCLUSIONS
We found that some common respiratory viruses, such as adenoviruses, enteroviruses, rhinoviruses, and coronaviruses, were associated with KD cases.
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: ly7077@tpts6.seed.net.tw.
Luan-Yin
LY
Chang
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chun-Yi
CY
Lu
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Pei-Lan
PL
Shao
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ping-Ing
PI
Lee
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ming-Tai
MT
Lin
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Tsui-Yien
TY
Fan
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ai-Ling
AL
Cheng
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Wan-Ling
WL
Lee
Department of Pediatrics, Taiwan Adventist Hospital, Taipei, Taiwan.
Jen-Jan
JJ
Hu
Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Shu-Jen
SJ
Yeh
Department of Pediatrics, Min-Sheng General Hospital, Tao-Yuan, Taiwan.
Chien-Chih
CC
Chang
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Bor-Luen
BL
Chiang
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Mei-Hwan
MH
Wu
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: lmhuang@ntu.edu.tw.
Li-Min
LM
Huang
D000258:Adenovirus Infections, Human / Q000150:complications* / Q000175:diagnosis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D018352:Coronavirus Infections / Q000150:complications* / Q000175:diagnosis; D004769:Enterovirus Infections / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis / Q000821:virology*; D010850:Picornaviridae Infections / Q000150:complications* / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012229:Rhinovirus / Q000302:isolation & purification*
Kawasaki disease; virus