Dr Arvind Kumar, Director and HOD, Paediatrics, Fortis Shalimar Bagh, spoke to indianexpress.com to explain what the disease is all about.
“Kawasaki disease is not new. Children with Kawasaki have been treated earlier also. In my experience, on average, there are about two to three children diagnosed with the disease in six months. Now they are coming in clusters, which most probably happened because a large part of the population is now suffering from COVID-19,” said Dr Kumar.
What is Kawasaki disease?
The origin of the Kawasaki disease is not exactly known. It is presumed that it is caused by a few viruses which trigger the disease, said the doctor. It was first discovered in Japan by Tomisaku Kawasaki, a paediatrician. This disease can happen to infants as well as children up to the age of 10-15 years. It is more common in children less than five years of age. As you grow, the incidence becomes lesser.
Symptoms of Kawasaki
Those with Kawasaki usually have high-grade fever, swollen lymph nodes, wet eyes, red lips and the surface of their tongue would be red and uneven, Dr Kumar highlighted. These symptoms would be irritable for children. Some also have joint pain and swelling in the limbs.
Most importantly, Kawasaki affects the heart as well, when the disease continues beyond a certain period, say about 10 days of illness, untreated. It can affect the coronary arteries. Of course, it does not happen in all children since nowadays the disease is diagnosed by the third or fourth day. “Early diagnosis and treatment are very important in case of Kawasaki disease to avoid complications,” the paediatrician emphasised.
How is Kawasaki treated?
Kawasaki is usually treated with anti-inflammatory drugs. Along with this, IVIG (Intravenous Immunoglobin). Majority of children would respond with a single dose of IVIG, after which the fever disappears and they are clinically much better, Dr Kumar explained.
How is Kawasaki related to COVID-19?
Some children who tested COVID-19 positive, are now showing symptoms of atypical Kawasaki and multisystem inflammatory syndrome (MIS). Dr Kumar remarked, “These children have high fever that is not remitting, redness of eyes, irritability, vomitting, and swelling in the limbs. But these symptoms are not a typical manifestation of Kawasaki but atypical Kawasaki, which means, they do not meet the criteria that have been laid down for diagnosis. So we can say COVID-19 infection in certain children is causing a hyper-inflammatory response, which is presenting as a manifestation of Kawasaki.”
Some of these children may also have what is known as Kawasaki with a shock–seizure inflammatory problem which leads to shock and cardiac involvement.
The doctor added, “Once Kawasaki is diagnosed, you have to investigate whether it is related to COVID -19 or not. There are two ways of doing this. One is nasal swabs; surprisingly, results for these children are coming negative after repeated tests. The other way out is to do the antibody test. When you do this test, there is some evidence of past infection of COVID-19, in the form of increased IgG levels (Immunoglobin G antibody).”