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Kawasaki syndrome - rugs, not motorcycles.


In 1967, a strange illness causing heart attacks in young children was first described in Japan. Seven years later, cases were recognized in Hawaii. Kawasaki syndrome, a disease named after the Japanese pediatrician who first discovered it among Japanese children in 1961, is now seen throughout the world, with 3,000 cases a year in the U.S. alone.

The disease begins with a rapidly rising fever, occurring several times a day for 5 to 21 days. A rash, looking much like that of measles, may also develop. Conjunctivitis, characterized by red eyes and swollen lids, usually without discharge, may develop in a day or so. The throat, tongue or lips may also be red and swollen. Palms and soles may swell at the same time, followed by peeling of the skin about two weeks later. About half of all cases will have swollen lymph nodes in the neck. The sharp increase in fever is always present; of the remaining five possible signs just noted, four must be present for an official diagnosis.

The cause is unknown, but a research group at Cornell University in New York has been trying for the past seven years to find a common factor among Kawasaki syndrome patients. A late 1989 report in Pediatrics, a journal devoted to children's diseases, found only one factor differentiating children with the disease from other children of the same age. Many of the sick children came from homes where rugs had been beaten, shampooed or otherwise vigorously cleaned within a month before the onset of illness!

Most of the families having a sick child, however, did not report cleaning rugs in the month before their child became ill, so this is just a clue, not the only explanation for the disease. Nevertheless, there was one case of a child who got the disease twice - and each time had been exposed to rug cleaning. So far, researchers have no clue as to what brings on the disease during the cleaning process. They therefore recommend that young children, especially through the toddler age, be sent elsewhere for a week or two if rugs are to be cleaned vigorously. Some pediatricians suggest that small children just not be allowed on a newly shampooed rug for at least two weeks, but not necessarily kept out of the house.

The disease is serious. Although less than 0.5 percent of Kawasaki patients die within the first month, as many as 20 percent may develop weak spots (aneurysms) in their coronary arteries. The damage probably results from some kind of immune response in these children, and aneurysms can be prevented if intravenous gamma globulin and aspirin are given within a week of the onset of illness. The procedure is expensive, however, costing about $2,000, so it is essential that the diagnosis not only be made promptly but accurately - which is not easy. Many cases are probably overlooked in busy pediatric practices, and until a laboratory test is devised to detect the disease, both parents and pediatricians will have to rely upon careful observation of children exhibiting the rapid fevers several times a day, as well as any of the other signs characteristic of the disease.
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Title Annotation:possible connection with rug-cleaning formulas
Publication:Medical Update
Date:Apr 1, 1990
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