KAWASAKI-DISEASEIN AUSTRALIA, 1993-95

Aim-To describe the epidemiology, management, and rate of cardiac sequ elae of Kawasaki disease in Australia. Design-Cases were notified to t he Australian Paediatric Surveillance Unit, an active national surveil lance scheme, from May 1993 to June 1995. Results-139 cases of Kawasak i disease were confirmed. In 1994, the annual incidence was 3.7/100 00 0 children < 5 years old. Sixteen children were not admitted to hospit al. Coronary artery abnormalities were reported in 35 (25%) children. Two patients were diagnosed at postmortem examination. Sixty six per c ent of patients were diagnosed within 10 days of onset and 81% of thes e received intravenous gammaglobulin within 10 days. Forty five of the notified children did not fulfil the study criteria because of strept ococcal infection or insufficient clinical criteria. One child with st reptococcal infection had coronary artery dilatation. Conclusion-Diagn osis of Kawasaki disease was delayed beyond 10 days in one third of pa tients, and almost 20% of children who could have received gammaglobul in within 10 days did not. The distinction between Kawasaki disease, s treptococcal infection, and other possible diagnoses is problematic in some children.