Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence

J Epidemiol. 2021 Nov 5;31(11):573-580. doi: 10.2188/jea.JE20210132. Epub 2021 Sep 17.


Background: Kawasaki disease is suspected to be triggered by previous infection. The prevention measures for coronavirus disease 2019 (COVID-19) have reportedly reduced transmission of certain infectious diseases. Under these circumstances, the prevention measures for COVID-19 may reduce the incidence of Kawasaki disease.

Methods: We conducted a retrospective study using registration datasets of patients with Kawasaki disease who were diagnosed in all 11 inpatient pediatric facilities in Yamanashi Prefecture. The eligible cases were 595 cases that were diagnosed before the COVID-19 pandemic (from January 2015 through February 2020) and 38 cases that were diagnosed during the COVID-19 pandemic (from March through November 2020). Incidence of several infectious disease were evaluated using data from the Infectious Disease Weekly Report conducted by the National Institute of Infectious Diseases.

Results: Epidemics of various infectious diseases generally remained at low levels during the first 9 months (March through November 2020) of the COVID-19 pandemic. Moreover, the incidence of COVID-19 was 50-80 times lower than the incidence in European countries and the United States. The total number of 38 cases with Kawasaki disease for the 9 months during the COVID-19 pandemic was 46.3% (-3.5 standard deviations [SDs] of the average [82.0; SD, 12.7 cases] for the corresponding 9 months of the previous 5 years. None of the 38 cases was determined to be triggered by COVID-19 based on their medical histories and negative results of severe acute respiratory syndrome coronavirus 2 testing at admission.

Conclusion: These observations provide a new epidemiological evidence for the notion that Kawasaki disease is triggered by major infectious diseases in children.

Keywords: COVID-19; Kawasaki disease; infectious disease; retrospective database.

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / prevention & control*
  • Child
  • Child, Preschool
  • Databases, Factual
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Japan / epidemiology
  • Male
  • Mucocutaneous Lymph Node Syndrome / diagnosis
  • Mucocutaneous Lymph Node Syndrome / epidemiology*
  • Pandemics / prevention & control*
  • Retrospective Studies