title: Evaluation of the Temporal Association between Kawasaki Disease and Viral Infections in South Korea.
abstract: OBJECTIVE
  This study is aimed at elucidating potential temporal associations between the occurrence of Kawasaki disease (KD) and various viral infections.
  
  
  METHODS
  We obtained monthly patterns of KD from the seventh nationwide survey and viral detection data from the Korea Centers for Disease Control and Prevention from 2009 to 2011 and evaluated temporal correlations between them for each month. The respiratory viruses detected using a multiplex real-time-polymerase chain reaction kit were influenza virus (A/H1N1, A/H3N2, A/H5N1, and B), adenovirus, parainfluenza virus (type 1, 2, 3), respiratory syncytial virus (type A, B), human rhinovirus, human coronavirus (OC43/229E, NL63), human bocavirus, and enterovirus.
  
  
  RESULTS
  We obtained data from a total of 13031 patients who were treated for acute KD from 87 hospitals with pediatric residence programs. During this survey, KD showed highest overall incidence in summer and winter seasons and lowest incidence in February and October. We received viral detection data for a total of 14267 patients. Viral detection was highest during winter and spring seasons. The most commonly detected virus was human rhinovirus (32.6%), followed by influenza virus (26.8%). The monthly incidence of KD showed significant correlation with the monthly overall viral detection (p=0.022, r=0.382). In particular, human bocavirus and enterovirus have significant correlations with monthly patterns of KD occurrence (p=0.032 and p=0.007, respectively) and influenza virus correlated with KD occurrence with borderline significance (p=0.063).
  
  
  CONCLUSIONS
  The temporal association between monthly occurrence of KD and viral detection suggests the etiologic importance of precedent infection in the development of KD.
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
authors.forename: Gi Beom
authors.initials: GB
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, Yonsei University, Seoul, Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
authors.forename: Bo Sang
authors.initials: BS
authors.lastname: Kwon
authors.affiliation: Department of Pediatrics, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
authors.forename: Ji Whan
authors.initials: JW
authors.lastname: Han
authors.affiliation: Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, Korea.
authors.forename: Yong Won
authors.initials: YW
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Ewha Womans University Hospital, Seoul, Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Hong
keywords: Association; Infection; Kawasaki disease
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