Abstract O.03: Monitoring the Occurrence of Kawasaki Syndrome in the United States

Abstract

Objectives: To describe the occurrence of Kawasaki syndrome (KS) in the United States. Methods: The Kids’ Inpatient Database (KID; 2003, 2006, 2009, 2012) and the Nationwide Inpatient Sample (NIS; 2001-2011) were analyzed to determine KS-associated hospitalization rates and trends; the United States Centers for Disease Control and Prevention (CDC; 2010-July 2014) passive KS surveillance database was analyzed to assess the frequency of coronary artery abnormalities (CAAs) among reported KS cases meeting the CDC KS case definition. Results: The KS-associated hospitalization rate for children <5 years of age using the KID was 18.1 (95% CI: 16.0-20.2) per 100,000 children in 2012, 20.0 (95% CI: 17.8-22.2) in 2009, 21.3 (95% CI: 18.9-23.7) in 2006, and 19.7 (95% CI: 17.7-21.7) in 2003. The 2012 KS-associated hospitalization rate was 21.0 (95% CI: 18.6-23.4) among males <5 years of age and 15.0 (95% CI: 13.0-17.0) among females. Asians/Pacific Islanders had the highest rate among all racial groups, 29.8 (95% CI: 22.2-37.4). The average annual KS-associated hospitalization rate for children <5 years of age using the NIS was constant from 2001-2011 at 18.8 per 100,000 per year (95% CI: 17.3-20.3; p=0.16) with peaks in 2005 (27.0 per 100,000; 95% CI: 19.3-34.7) and, to a lesser extent, in 2010 (22.6 per 100,000; 95% CI: 16.6-28.5). The CDC surveillance database included 497 physician-diagnosed KS cases <18 years of age reported with onset occurring January 1, 2010 through July 31, 2014; about three-quarters (n=372) of the cases met the CDC KS case definition. Among KS cases meeting this definition that also contained complication data, 18.7% (69/369) had CAAs reported; among Asian/Pacific Islander children, 24.7% (18/73) had CAAs reported. Almost all KS cases in the database (98.1%, 363/370) were treated with intravenous immunoglobulin. Conclusions: Analyses of KID and NIS data did not indicate any increase in KS-associated hospitalization rates for children <5 years of age in the United States through 2012. CAAs continue to occur at a comparable rate with past reports.