title: Recurrent Kawasaki disease: USA and Japan.
abstract: BACKGROUND
  Descriptive epidemiologic studies of recurrent and non-recurrent Kawasaki disease (KD) may identify other potentially important differences between these illnesses.
  
  
  METHODS
  Data from the USA and Japan, the Centers for Disease Control and Prevention (CDC) national KD surveillance(1984-2008) and the 17th Japanese nationwide survey (2001-2002), respectively, were analyzed to examine recurrent KD patients <18 years of age meeting the CDC KD case or atypical KD case definition. These patients were compared with non-recurrent KD patients.
  
  
  RESULTS
  Of the 5557 US KD patients <18 years of age during 1984-2008, 97 (1.7%) were identified as having had recurrent KD. Among the US Asian/Pacific Islander KD patients, 3.5% had recurrent KD, which was similar to the percentage identified among KD patients (3.5%) in the Japanese survey. Compared with non-recurrent KD patients, KD patients [with recurrent KD] were more likely to be older, fulfill the atypical KD case definition, and have coronary artery abnormalities (CAA) despite i.v. immunoglobulin (IVIG) treatment.
  
  
  CONCLUSIONS
  Differences in the age, race, and frequency of CAA exist between recurrent and non-recurrent KD patients. The increased association of CAA with recurrent KD suggests that more aggressive treatment strategies in conjunction with IVIG may be indicated for the second episode of KD.
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Maddox
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.affiliation: Utsunomiya City Public Health Center, Utsunomiya City, Tochigi, Japan.
authors.forename: Ritei
authors.initials: R
authors.lastname: Uehara
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Callinan
authors.affiliation: Emory University School of Medicine/Rollins School of Public Health, Atlanta, Georgia, USA.|Atlanta VA Medical Center, Decatur, Georgia, USA.
authors.forename: Jodie L
authors.initials: JL
authors.lastname: Guest
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Schonberger
authors.affiliation: Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yashiro
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Ermias D
authors.initials: ED
authors.lastname: Belay
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D009017:Morbidity / Q000639:trends; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology; D011159:Population Surveillance; D012008:Recurrence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Kawasaki disease; Kawasaki syndrome; epidemiology; mucocutaneous lymph node syndrome; recurrence