590 EPIDEMIOLOGY OF KAWASAKI SYNDROME (KS) IN AN AREA WITH A SMALL ASIAN POPULATION

Abstract

Cases of KS in the Chicago area during 1979-83 were identified retrospectively from pediatric echocardiographic facilities in metropolitan Chicago and from a random sample of community hospitals. We identified 190 children with KS who underwent echocardiography. Male:female ratio was 1.58:1 (p<0.05). 117 (62%) of patients were white, 61 (32%) were black, and 12 (6%) were Asian, the latter slightly over-represented (p<0.1). Mean age at diagnosis was 3.1 yrs. Incidence peaked in the 2nd and 4th quarters of the years (p<0.005), especially in Apr, May, Nov, and Dec (p<0.05), and was lowest in July-Sept. Cases were endemic with two superimposed Spring clusters in 1980 and 1983. By echocardiography, 30/190 (16%) had coronary aneurysms: 22/115 boys (19%) and 8/75 (11%) girls (p∼0.1). The incidence of aneurysms did not vary by month, season, or year. Aneurysms were present in 0/10 Asians, 7/61 (11.5%) blacks, 22/117 (19%) whites and 1/2 mixed Asian/whites (p∼0.1). Aneurysms were diagnosed in a higher percentage of children <2 yrs (17/78-22%) than >2 yrs (13/122-12%) (p∼0.07). Whites <2 yrs are a subgroup with a high incidence of aneurysms (17/55-31%), significantly greater than all others (13/135--10%) (p<0.005) and non-whites <2 yrs (1/23-4%) (p<0.01). Thus, in the Chicago area, where Asians comprise a small fraction of the population, KS was diagnosed most often in white children, and white children <2 yrs had the highest incidence of coronary aneurysms diagnosed by echocardiography.

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