Environmental factors may influence the incidence of Kawasaki disease


December 05, 2018

2 minute read

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Photo by Jane Burns

Jane C. Burns

Weather conditions in Southern California may impact the distribution of Kawasaki disease, according to a study published in Scientific reports.

Jane C. Burns, MD, The director of the Kawasaki Disease Research Center at the University of California, San Diego School of Medicine, and his colleagues have speculated that there are potentially multiple triggers that can cause the disease, such as a genetic predisposition, as well as wind patterns and other environmental exhibits.

“Researchers in Chicago are working on the concept that Kawasaki disease is caused by a new virus and a single agent,” Burns said. Infectious diseases in children. “The data from this paper and other work we’ve done, as well as researchers in Japan, suggest that there could be more than one trigger for the disease. There’s not an infinite number, but there are different triggers that lead to a slightly different flavor of immune response.

Burns and his colleagues noted that Kawasaki disease is relatively rare in American children, with fewer than 6,000 developing the disease each year. However, in San Diego County, the incidence of Kawasaki disease has increased in children under age 5 – from 10 per 100,000 in the 1990s to 25.5 per 100,000 in 2006-2015. It is currently unknown which etiological agent triggers Kawasaki disease, and “extensive searches for an infectious agent have not yielded a consistent pathogen,” the researchers wrote.

According to Burns and colleagues, 1,164 patients with Kawasaki disease were treated at Rady Children’s Hospital in San Diego over a 15-year period. The researchers observed a seasonal pattern of cases, peaking from January to March and peaking again to a lesser extent in June.

Researchers also observed “highly significant” regional air temperature anomalies and large-scale wind patterns that contributed to disease incidence. Burns said it’s possible a trigger for the disease is carried by the wind.

Moreover, when the researchers analyzed the gene expressions of the patients, they found distinct groups of patients. Children in each group had similar ages and inflammation measurements.

“When we went back and asked ourselves if the patients were clinically different from each other, we found [three clusters of disease, and] one of the three groups had much higher inflammation,” Burns said. “That was the illuminating moment for us when we realized that these patients were clustering in time and space, but there was a sporadic background of patients. There were only 39 clusters, but clusters had at least five or more patients over a 7-day period.


Burns said until there is a clear answer as to why these cases are happening, all hypotheses are viable. Currently, a team of climatologists is studying the effects of wind and weather patterns on the development of Kawasaki disease, cluster by cluster.

Another possibility, according to Burns, is that unknown exposure intensity may be contributing to disease clusters. She said it’s possible that some children were more exposed to a trigger than others. These exposures could occur through the upper respiratory tract and trigger a genetic response.

She added that a “fruitful area of ​​research” is in Japan, where there are more cases of Kawasaki disease and where the seasonal peak in incidence has been clearly defined.

“We are working with climatologists there to try to understand what the children’s exposures might be,” she said. “Previous data from our climate science group suggests that it is something in the wind carried from northeast China. Our climate team is working with Chinese scientists in the potential source region to try to make aerosol scans to see if we can identify anything that could be blown by the wind blowing towards Japan and triggering children there. by Katherine Bortz

Disclosure: Burns does not report any relevant financial information.


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