What is it?
Kawasaki disease (KD) is the second most common form of vasculitis (inflammation of blood vessels) in childhood, affecting 200-300 Australian children every year. It mostly occurs in children aged under 5, with some rare cases affecting older children or adults. KD is a collection of symptoms including persistent fever, conjunctival infection, rash, painful oedema of the hands and feet, lymphadenopathy and oral symptoms such as strawberry tongue, erythema and cracking and bleeding of the lips. Children with KD are at risk of developing coronary artery aneurysms, and in some cases damage to the heart valves or muscle, if prompt treatment is not initiated. Up to 10% of children with KD will go on to develop problems with the coronary arteries, and it is the most common form of acquired heart disease in children in developed nations.
Treatment
Morbidity and mortality is reduced by the prompt initiation of treatment with the administration of intravenous immunoglobulin (IVIg). IVIg prevents damage to large arteries of the heart in 80% of cases. Low dose aspirin is prescribed for a few weeks following diagnosis to prevent cardiac complications.
Kawasaki disease and immunisation
There is no evidence that vaccination can lead to KD. Whilst a diagnosis of KD may be made following immunisation, this association is temporal and research has not identified a causal association.
Due to the inflammation that occurs with KD, BCG administration sites can become inflamed during the illness if BCG was administered in the 6 months prior.
Vaccine precautions
Inactivated routine vaccines can be administered as per the National Immunisation Program (NIP) once a child has recovered from the acute illness.
Live-attenuated vaccines such as measles-mumps-rubella-varicella and measles-mumps-rubella must be delayed 11 months following the administration of intravenous immunoglobulin (IVIg) as the transfusion of IVIg can affect the immune response to the vaccine.
Resources
- MVEC: Live-attenuated vaccines and immunoglobulins or blood products
- MVEC: Children with cardiac disease
- RCH Kids Health Information: Kawasaki disease
- RCH Clinical practice guidelines: Kawasaki disease
- Kawasaki Disease Foundation
Author: Adele Harris (SAEFVIC Research Nurse, Murdoch Children’s Research Institute).
Reviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)
Date: June 2022
Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.