Published online February 23, 2009
PEDIATRICS Vol. 123 No. 3 March 2009, pp. e401-e405 (doi:10.1542/peds.2008-2187)

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ARTICLE

Epidemiologic Features of Kawasaki Disease in Taiwan, 2003–2006

Wen-Chan Huang, MD^a, Li-Min Huang, MD, PhD^a, I-Shou Chang, PhD^b, Luan-Yin Chang, MD, PhD^a, Bor-Luen Chiang, MD, PhD^a,c, Pei-Jer Chen, MD, PhD^c,d, Mei-Hwan Wu, MD, PhD^a, Hung-Chi Lue, MD, PhD^a,e, Chun-Yun Lee, MD^a and the Kawasaki Disease Research Group

Departments of ^a Pediatrics
^d Medical Research
^c Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
^b Biostatistics and Bioinformatics, National Health Research Institutes, Miaoli, Taiwan
^e Department of Pediatrics, Lotung St Mary's Hospital, I-Lan, Taiwan

OBJECTIVE. Kawasaki disease is the leading cause of acquired heart disease in children worldwide. This study characterizes the epidemiology of Kawasaki disease in Taiwan between 2003 and 2006.

METHODS. Using Taiwan's 2003–2006 national health insurance claims, we investigated the epidemiologic features of Kawasaki disease (ICD-9-CM code 446.1) and coronary artery aneurysm formation (International Classification of Diseases, Ninth Revision, Clinical Modification code 414.11) and compared the incidences of these diseases with those occurring between 1996 and 2002 in Taiwan and those reported by other countries.

RESULTS. During our 4-year study period, 3877 children and adolescents <20 years of age were hospitalized for Kawasaki disease. Ninety percent of these children were <5 years of age, and the male/female ratio was 1.62:1. The annual incidence of Kawasaki disease was 153 in 100000 children <1 year of age, 111 in children 1 year of age, 58 in children 2 years of age, 30 in children 3 years of age, 19 in children 4 years of age, and 5.2 in children 5 to 9 years of age. The overall incidence was 69 cases per 100000 for children <5 years of age. Kawasaki disease recurred in 1.5% of all cases. Kawasaki disease occurred most frequently in the summer and least frequently in the winter. Coronary artery aneurysm occurred in 7.2% (279 of 3877) of all Kawasaki disease cases.

CONCLUSIONS. The overall incidence of Kawasaki disease was 69 in 100000 children <5 years of age between 2003 and 2006 in Taiwan, comparable with the incidence of 66 in 100000 children between 1996 and 2002. Taiwan has the third highest incidence of Kawasaki disease in the world, after Japan and Korea. In Taiwan, it occurs more frequently during the summer.

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Key Words: Kawasaki disease • incidence • seasonality • Taiwan

Abbreviations: KD—Kawasaki disease • CAA—coronary artery aneurysm • NHI—national health insurance • ICD-9-CM—International Classification of Diseases, Ninth Revision, Clinical Modification • SARS—severe acute respiratory syndrome • IVIg—intravenous immunoglobulin

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Accepted Dec 2, 2008.

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