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      Descriptive Epidemiology of Kawasaki Disease in Japan, 2011–2012: From the Results of the 22nd Nationwide Survey Translated title: 日本における川崎病の疫学像:2011-2012年の全国調査結果

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          Abstract

          Background

          The number of patients and incidence rate of Kawasaki disease (KD) are increasing in Japan. We have therefore characterized the latest epidemiological information on KD.

          Methods

          The 22nd nationwide survey of KD, which targeted patients diagnosed with KD in 2011 and 2012, was conducted in 2013 and included a total of 1983 departments and hospitals. In order to report on all patients with KD during the 2 survey years, we targeted hospitals of 100 beds or more with pediatric departments, or specialized pediatric hospitals.

          Results

          From a total of 1420 hospitals and departments (71.6% response rate), 26 691 KD patients were reported (12 774 in 2011 and 13 917 in 2012; 15 442 males and 11 249 females). The annual incidence rates were 243.1 per 100 000 population aged 0 to 4 years in 2011 and 264.8 in 2012. The number of cases of KD recorded in 2012 was the highest ever reported in Japan. The incidence rate of complete cases was also the highest ever reported in Japan and contributed to the increase in the rate of total cases in recent years. The number of patients diagnosed per month peaked in January, and additional peaks were noted during summer months, although these peaks were lower than those seen in winter. Age-specific incidence rate showed a monomodal distribution with a peak in the latter half of the year in which patients were born.

          Conclusions

          The number of patients and the incidence rate of KD in Japan continue to increase. A similar trend has also been seen for patients with complete KD.

          Translated abstract

          背景:

          日本では川崎病の患者数、罹患率ともに増加の一途をたどっている。今回、川崎病の最新の疫学データを解析した。

          方法:

          第22回川崎病全国調査を2013年に行った。2011年および2012年に川崎病を診断した1983施設を対象とした。小児科を標榜する100床以上の病院、および小児病院を対象とし、2年間の調査期間中に川崎病と診断されたすべての患者の報告を求めた。

          結果:

          1420施設(回収率71.6%)から, 26,691人(2011年12,774人、2012年13,917人)の川崎病患者が報告された。男15,442人、女11,249人であった。0-4歳人口10万対罹患率は2011年243.1、2012年264.8であり、2012年の患者数は日本で報告されたものの中では最高であった。2012年の定型例の罹患率も日本で報告されたものの中で最高であり、近年の罹患率の増加に寄与した。月別推移では1月に患者数のピークがあり、夏にも1月に比べると低いピークがあった。年齢別罹患率では月齢6か月以内にピークを持つ一峰性の分布が見られた。

          結論:

          川崎病の患者数および罹患率は日本においては増加し続けている。定型例においても同様の傾向が認められた。

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          Most cited references20

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          Kawasaki syndrome.

          Kawasaki syndrome is an acute, self-limited vasculitis that occurs in children of all ages and presents a challenge for the clinician: the disorder can be difficult to recognise; there is no diagnostic laboratory test; there is an extremely effective therapy; and there is a 25% chance of serious cardiovascular damage if the treatment is not given early in the course of the disease. This review includes discussion of the history of the syndrome, the diagnostic challenges, epidemiology, aetiology, pathology, immunopathogenesis, therapy, genetic influences, and the long-term cardiovascular sequelae.
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            Epidemiologic Features of Kawasaki Disease in Japan: Results of the 2009–2010 Nationwide Survey

            Background Although the number of patients and incidence rate of Kawasaki disease (KD) are increasing in Japan, the most recent epidemiologic features of KD are not known. Methods The 21st nationwide survey of KD was conducted in 2011 and included patients treated for the disease in 2009 and 2010. Hospitals specializing in pediatrics, and hospitals with a total of 100 or more beds and a pediatric department, were asked to report all patients with KD during the 2 survey years. Results A total of 1445 departments and hospitals reported 23 730 KD patients (10 975 in 2009 and 12 755 in 2010): 13 515 boys and 10 215 girls. The annual incidence rates were 206.2 and 239.6 per 100 000 children aged 0 to 4 years in 2009 and 2010, respectively; the 2010 rate was the highest ever reported in Japan. Monthly number of patients peaked during winter to spring months; lower peaks were noted during summer months. However, the seasonal patterns in 2009 and 2010 differed from those of previous years. The age-specific incidence rate had a monomodal distribution, with a peak during the latter half of the year of birth. The prevalences of cardiac lesions during acute KD and cardiac sequelae were higher among infants and older age groups. Despite a decrease in prevalence, the proportion of patients with giant coronary aneurysms—the most severe sequela of KD—did not substantially decrease. Conclusions The incidence rate and number of patients with KD continue to increase in Japan.
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              Kawasaki disease in families.

              The rate of second-case Kawasaki disease occurring among 1788 siblings of children with the disease was derived from data obtained from questionnaires mailed to the members of the Japanese Association of Parents of Children With Kawasaki Disease. Within 1 year after the onset of the first case in a family, the overall second-case rate was 2.1% for siblings, as compared to an overall incidence of approximately 0.19% in the general population of children 0 to 4 years of age in Japan in the epidemic year 1982. For siblings younger than 1 year of age, it was 8.4%, and for those between 1 and 2 years of age, it was 9.3%. More than half (54.1%) of the second cases developed 10 days or less after the first cases occurred.
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 March 2015
                7 February 2015
                2015
                : 25
                : 3
                : 239-245
                Affiliations
                [01]Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan 自治医科大学地域医療学センター公衆衛生学部門
                Author notes
                Address for correspondence. Nobuko Makino, Department of Public Health, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan (e-mail: n-makino@ 123456jichi.ac.jp ).
                Article
                JE20140089
                10.2188/jea.JE20140089
                4341001
                25716368
                8cb7d3fe-6ec9-4225-bfb0-19567241e24a
                © 2015 Nobuko Makino et al.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 May 2014
                : 20 October 2014
                Categories
                Original Article
                Clinical Epidemiology

                mucocutaneous lymph node syndrome,incidence,cardiovascular disease,intravenous immunoglobulin,epidemiology

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