KAWASAKI SYNDROME IN WASHINGTON-STATE - RACE-SPECIFIC INCIDENCE RATESAND RESIDENTIAL PROXIMITY TO WATER

Objectives: To calculate race-specific incidence rates of Kawasaki syn drome (KS) and to assess the association of KS with residential proxim ity to water in Washington State. Design: Incidence study over 4 1/2 y ears, using cases identified with a new statewide hospital data set an d a case-control study. Setting: King, Pierce, and Snohomish counties in Washington State. Patients: One hundred twelve population-based inc ident cases meeting Centers for Disease Control and Prevention criteri a for KS. Main Outcome Measures: Race-specific KS incidence rates and distance to permanent bodies of water among KS cases and matched contr ols. Results: For the years 1985 through 1986 and 1987 through 1989, t he annual KS incidence rates were 6.5 and 15.2 per 100 000 children yo unger than 5 years, respectively. Rates were highest among Asian Ameri cans (33.3 per 100 000 children younger than 5 years in the 1987-1989 period), followed by blacks and whites (23.4 and 12.7 per 100 000 chil dren younger than 5 years, respectively). The median distance to water did not differ between cases and controls and the proportion of cases living within 150 yd (135 m) of water was no greater than that of con trols (odds ratio, 1.0; 95% confidence interval, 0.1 to 20.9). Conclus ions: With complete ascertainment of incident-hospitalized cases of KS , the race-specific rates are among the highest documented in the Unit ed States. The rate among Asian Americans was less than that found in Japan, perhaps due to differences in environmental exposures or variat ions in susceptibility among different Asian ethnic groups. Although w e found no association with permanent bodies of water, future studies of KS should include home inspection to assess exposure to temporary c ollections of standing water.