Has your little one had a fever for a few days? Should we be aware of this Kawasaki Disease?

As a mother or father, it is difficult to put into words the fear and anxiety we feel when our little one gets sick, isn't it? Even a common cold or fever can make us anxious. So, it is not surprising that our hearts flutter when our child shows some unusual symptoms. Today we are going to talk about a disease that you may not have heard of, but is very important to know about. That is Kawasaki disease , or ``Kawasaki Disease``. Don't worry, this is a completely curable condition if recognized early and treated properly.

What is Kawasaki Disease? Simply put...

Simply put, Kawasaki disease is a condition in which the walls of the blood vessels (blood vessels) in our body become swollen or inflamed . It mainly affects young children, under the age of five, and more commonly seen in babies between the ages of 6 months and 2 years. However, although rare, it can also affect older children and young adults.

This disease was first discovered and described by a Japanese doctor, Dr. Tomisaku Kawasaki. That's why it's called Kawasaki disease.

The most important thing is that this is not a contagious disease . This means that it cannot be spread from your child to another person. So don't worry about it.

This disease mainly affects the blood vessels that carry blood to the heart. We call them the coronary arteries . If those vessels become inflamed, it can have some effects on the heart. That's why we're so concerned about this disease.

How is this disease diagnosed? What are the symptoms?

The symptoms of Kawasaki disease are a bit peculiar. They don't usually appear all at once, but rather gradually. Doctors use a little trick to remember these symptoms, called "CRASH and Burn." Let's take a look at what they are.

• "Burn" (fever): This is the main and first symptom. There is a high fever for five or more days . This fever can sometimes reach 39-40 degrees Celsius (102-104 Fahrenheit). Even with common fever-reducing medications, this fever rarely subsides.

Now let's see what "CRASH" means:

• C - Conjunctivitis (redness of the eyes): The whites of both the child's eyes turn red . It's like an eye infection. But the special thing is, there are no tears coming out. It's just red.
• R - Rash: Red, itchy patches appear all over the body, especially on the chest, stomach, back, and sometimes the arms and legs. These patches can come in many shapes. Some children may notice these patches more often in the diaper area (thighs and buttocks).
• A - Adenopathy: A lymph node (node) in the neck, usually on one side, becomes swollen . This can be large enough to be felt, sometimes larger than 1.5 centimeters.
• S - Strawberry tongue and other mouth changes:
• The child's lips may become dry, cracked, and sometimes red enough to bleed .
• The tongue is initially covered with a white coating, which later disappears and the tongue turns red, with small bumps appearing, and it looks like a strawberry . That's why it's called "strawberry tongue."
• The inside of the mouth and throat may also become red.
• H - Hands and feet changes:
• In the early days, the palms and soles of the feet become red and swollen . It may feel like the limbs are swollen.
• After about a week and a half to two weeks, the skin will start to peel off from the fingertips and sometimes the palms and soles of the feet . This can come off in large flakes.

In addition to these main symptoms, some children may experience other difficulties. For example:

• Very irritable, crying .
• Vomiting, stomach pain, diarrhea.
• Joint pain and swelling.
• Sometimes symptoms such as jaundice may also appear.

Just think, if your little one's fever doesn't go down for 4-5 days, and they're also showing some of the symptoms mentioned above, you should definitely see a doctor.

Why does this happen? What causes Kawasaki disease?

In fact, the exact cause of Kawasaki disease is still unknown . Doctors and scientists are still researching this. However, there are several factors that are thought to be responsible for it:

• An infection: It's thought that the body's immune system may be overactive and attacking its own blood vessels due to something like a bacteria or virus. But it's not exactly known what germ it is.
• Genetic predisposition: It has been found that children in some families are slightly more likely to develop this. This means that there may be some genetic connection. However, this is not a disease that is directly inherited from parents to children.
• Environmental factors: We are also investigating whether some environmental factors also affect this.

The most important thing is that this is not a disease caused by any mistake you made. Don't worry about it.

How do doctors diagnose this? (Diagnosis)

There is no single definitive test to diagnose Kawasaki disease. That is, there is no test that can take a little blood and say, "Oh, here's Kawasaki."

A doctor will determine whether or not the child has this condition based primarily on the symptoms they are experiencing. If several of the aforementioned "CRASH and Burn" symptoms have been present for a period of time, the doctor may become suspicious.

In addition, a doctor may do things like:

• Examine the child carefully: Check for fever, eyes, mouth, skin, neck, and limbs.
• Blood tests:
• Tests such as `(CRP - C-Reactive Protein)` and `(ESR - Erythrocyte Sedimentation Rate)` are done to see if there is inflammation in the body. If you have Kawasaki, these can be very high.
• The number of white blood cells and platelets is checked.
• Liver function tests may also be performed.
• Urine tests: Help rule out other infectious conditions.
• Heart test `(Echocardiogram - Echo)`: This is a very important test . This can check the function of the heart, the valves of the heart, and especially the condition of the coronary arteries. This test can detect whether these arteries are swollen and enlarged (aneurysm) in Kawasaki disease. This `(Echo)` test is usually done after the disease is diagnosed, after a few weeks.

The doctor will combine all of this to decide whether it is Kawasaki disease or not.

What happens if it is not treated? Is this dangerous?

Kawasaki disease can lead to complications if not treated promptly and properly . That's why it's important to recognize it early and start treatment.

The most important and dangerous complication is the expansion of the coronary arteries (Coronary Artery Aneurysms). This means that the blood vessels that supply blood to the heart swell like a balloon. If such an ``(Aneurysm)`` occurs, blood flow through it can be obstructed, blood clots can form, and sometimes the artery can burst (this happens very rarely). This increases the risk of heart attacks in the future.

Other complications:

• Myocarditis
• Inflammation of the membrane surrounding the heart (pericarditis)
• Heart valve problems
• Heartbeat irregularities (Arrhythmias)

But don't be afraid to hear these things. If Kawasaki disease is recognized early and treatment is started within 10 days of the onset of symptoms, the risk of these complications can be greatly reduced. That's why we say see a doctor as soon as possible.

How is this treated?

If the doctor confirms that the child has Kawasaki disease, the child will be hospitalized and treated . This cannot be treated at home.

There are two main treatment methods:

1. Intravenous Immunoglobulin (IVIG): This is the main treatment. IVIG is a solution containing antibodies taken from healthy people. It is given to the child through a vein, like saline. It calms the overactive immune system in the body and reduces swelling in the blood vessels. It is usually given once, and it takes about 8-12 hours to complete.

2. Aspirin:

• Initially, high doses of aspirin are given until the fever subsides and the inflammation in the body subsides.
• After that, low-dose aspirin should be given for about 6-8 weeks, or even longer, to prevent blood clots in the coronary arteries. The doctor will decide the duration based on the child's echocardiogram.

We generally do not recommend giving aspirin to children because it can cause a dangerous condition called Reye's Syndrome. However, in Kawasaki disease, the benefits of aspirin far outweigh the risks. Therefore, it is given on the advice of a doctor.

During treatment, doctors and nurses monitor the child closely, constantly monitoring heart function, fever, and other symptoms.

What happens after treatment? Will the child return to normal?

In most cases, within a day or two of starting IVIG treatment, the child's fever will subside and other symptoms will gradually improve. The child will begin to feel better.

These things are important after treatment:

• Follow-up appointments: After leaving the hospital, you should take your child to the doctor's appointments.
• Repeated `(Echocardiogram)` tests: `(Echo)` tests will be done every few weeks to every few months to check the condition of the coronary arteries. How often this is done will depend on the condition of the child's heart.
• Continue to give low-dose aspirin: Do not stop giving low-dose aspirin until your doctor tells you to.
• Be careful of catching a cold or flu: If your child gets chickenpox or influenza while taking aspirin, there is a risk of Reye's Syndrome, so keep your child away from people with such illnesses. It is also a good idea to get your child vaccinated against influenza every year as advised by your doctor.
• Postponing some vaccines: Your doctor may advise you to postpone some live virus vaccines (e.g. measles, mumps, rubella - MMR, chickenpox vaccine) for a few months due to IVIG treatment. Talk to your doctor about this as well.

The good news is that if Kawasaki disease is treated promptly, most children make a full recovery and can live normal lives without any long-term effects on their hearts.

Do I need to see a doctor? When should I go?

Yes, absolutely. If your child has any of these symptoms, you should see a doctor immediately .

Be especially careful about these things:

• A high fever that lasts more than 4-5 days , especially if it does not subside with regular fever medications.
• If the fever is accompanied by one or more symptoms such as red eyes, chapped lips, changes in the tongue, body spots, swelling of the limbs, and a lump on the neck .

Kawasaki disease is a relatively rare disease. However, it can sometimes be difficult to distinguish it from other common viral illnesses. Therefore, if you have any doubts, if you think "this doesn't seem like a common illness," it is best to see a doctor for advice. The earlier it is diagnosed, the sooner treatment can begin, and the lower the risk of complications.

Finally, things to remember (Take-Home Message)

As a parent, you may be concerned about Kawasaki Disease. That's normal. But keep these things in mind:

• Kawasaki disease is a condition that causes swelling of the blood vessels in young children .
• The main symptoms are a high fever that lasts for several days, red eyes, changes in the mouth and lips, rashes, swelling of the limbs and then peeling of the skin, and swollen lymph nodes in the neck .
• This is not a contagious disease .
• Although the exact cause is not known, it can be completely cured if treated on time .
• If left untreated, it can affect the blood vessels in the heart . That's why prompt treatment is important.
• Treatment is by hospitalization and medications called `(IVIG)` and `(Aspirin).`
• If your child has these symptoms, see a doctor immediately. It's important not to panic, but to act quickly.

Wishing your child a speedy recovery! I hope this information is helpful to you.

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