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Resurgence of Kawasaki Disease Following Relaxation of Coronavirus Disease 2019 Pandemic Restrictions in Japan - 08/11/24

Doi : 10.1016/j.jpeds.2024.114251 
Fumio Nakata, MD 1, Kousaku Matsubara, MD, PhD 1, , Keigo Hamahata, MD, PhD 2, Chisato Miyakoshi, MD, PhD 3, Shogo Minamikawa, MD, PhD 4, Kunitaka Ota, MD, PhD 5, Takahiro Okutani, MD, PhD 6, Rika Yamaoka, MD 7, Junji Eguchi, MD, PhD 8, Ikuyo Ueda, MD, PhD 9, Naoki Yokoyama, MD, PhD 10, Tomoko Horinouchi, MD, PhD 11, Sadayuki Nukina, MD, PhD 12
1 Department of Pediatrics, Kobe City Nishi-Kobe Medical Center, Kobe, Japan 
2 Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe, Japan 
3 Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan 
4 Department of General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan 
5 Department of Pediatrics, Konan Medical Center, Kobe, Japan 
6 Department of Pediatrics, Saiseikai Hyogo-ken Hospital, Kobe, Japan 
7 Department of Pediatrics, National Hospital Organization Kobe Medical Center, Kobe, Japan 
8 Department of Pediatrics, Kobe City Medical Center West Hospital, Kobe, Japan 
9 Department of Pediatrics, Japan Community Health Care Organization Kobe Central Hospital, Kobe, Japan 
10 Department of Pediatrics, Akashi Medical Center, Akashi, Japan 
11 Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan 
12 Department of Pediatrics, Akashi City Hospital, Akashi, Japan 

Reprint requests: Kousaku Matsubara, MD, PhD, Department of Pediatrics, Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe 651-2273, Japan.Department of PediatricsNishi-Kobe Medical Center5-7-1 KojidaiNishi-kuKobe651-2273Japan

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Abstract

Objective

To compare the number and incidence of Kawasaki disease (KD) patients in years 2 through 4 of the coronavirus disease 2019 pandemic, and determine the impact of 3 years of implementation of infection control measures and their subsequent relaxation on the epidemiology of KD in Japan.

Study design

We conducted a population-based, cohort study including consecutive KD patients in Kobe City between 2021 and 2023. We compared the incidence of KD cases, in relation to timing of infection control measures, as well as infectious disease cases based on a regional surveillance system. Data from a previous 2016 through 2020 study were used for comparison.

Results

A total of 566 children with KD were identified during the study period. During the infection control period in 2021 to 2022, the incidence of KD remained low compared with the prepandemic level (281.3 and 327.5/100 000 children aged 0-4 years in 2021 to 2022 and 2016 through 2019, respectively), but a recovery trend began in the 0-1-year age group. During the relaxation period in 2023, the incidence of KD increased across a wide-age range, reaching the highest recorded in Japan (426.7/100 000 children aged 0-4 years), and the median age of onset increased to age 30 months. The resurgence of KD coincided with the epidemic patterns for multiple infectious diseases in 2023. The seasonality of KD observed before the pandemic was altered.

Conclusions

KD resurged in 2023 after relaxation of the prolonged coronavirus disease 2019 pandemic restrictions in Japan. This phenomenon coincided with the rise of multiple infectious diseases, and supports the pathogenesis of KD being triggered by infectious agents.

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Keywords : annual incidence, epidemiology, nonpharmaceutical intervention, pathogenesis, pediatric infectious disease

Abbreviations : COVID-19, IVIG, KD, MIS-C, NPIs, RSV


Plan


 Data Availability Statement: FN and KM had full access to the data in the study and take responsibility for their accuracy and integrity. Data are available upon reasonable request.


© 2024  Elsevier Inc. Tous droits réservés.
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Article 114251- décembre 2024 Retour au numéro
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