Background: Kawasaki disease is the leading cause of acquired heart disease in non-Indigenous Australian children. Its cause remains unknown, but its incidence increasing worldwide. We aimed to assess trends in Kawasaki disease in Australia.
Method: Analysis of National Hospital Morbidity Database hospital separations with a principal diagnosis of Kawasaki disease. Limited to persons aged under 20 years.
Results: There were 6,368 hospitalisations for Kawasaki disease between 1993-94 to 2017-18. Pre-school-aged children were over-represented with 15.8% of separations in infants less than one year and a further 58.7% for those aged 1-4 years. Hospitalisations were also more common for boys (male to female ratio 1.5:1). The hospitalisation rate increased from 5.2 separations per 100,000 population in 1993-94 to 12.4 per 100,000 in 2019-2018.
Discussion: Kawasaki disease is uncommon in Australia, but its incidence is increasing. Prompt treatment with intravenous immunoglobulin significantly reduces cardiovascular complications such as coronary artery aneurysms from 25% to 4%. GPs are likely to assess children with persisting fevers who may have Kawasaki disease.
Implications for practice: Kawasaki disease is a clinical diagnosis, and it may not present with the classical features such as oropharyngeal erythema, bilateral conjunctival injection, rash, or unilateral cervical lymphadenopathy. Children with persisting fevers are likely to be seen in primary care, so general practitioners need a high degree of suspicion to detect this uncommon but important condition.