First-known Reported Kawasaki Disease Outbreak in the Philippines, 2010

Background: On June 19, 2010, 10 cases of highly suspicious Kawasaki Disease cases were reported to the National Epidemiology Center. An FETP team was sent to conduct an epidemiological investigation. The objectives were to verify the disease, identify the clinical manifestations, and recommend control and preventive measures. Methods: A descriptive study was done. An ill patient was a resident of 3 municipalities in Nueva Ecija with fever of 5 or more days and the presence of at least 4 of the following: edema or desquamation of extremities, polymorphic exanthema, bilateral conjunctival congestion, oral mucosal changes and/or cervical lymphadenopathy from February 4 to June 24, 2010. Medical records from two hospitals were reviewed. Cases were traced back and interviewed using a questionnaire. Further work-up and application of the American Society of Pediatrics (ASP) Syndromic Guidelines in the diagnosis of Kawasaki Diseases were done to exclude other diseases. Results: Four cases were diagnosed as Kawasaki Disease. Age ranged from 3 months to 8 years (median 4 years). Three were males. All had fever of more than 5 days. All cases met the syndromic criteria of Kawasaki Disease of the ASP. Further, blood examination was negative for measles IgM. Conclusion: This was the first reported outbreak of Kawasaki Disease in the Philippines. This was reported because of the enhanced clinical practice guidelines. However, the cause of the disease and outbreak remained unclear. Health education activities were conducted. It is recommended to include this disease as one of the differential diagnosis of fever and rash admissions. Continuous surveillance should be done to further characterize the disease. Special studies should be done to establish the cause and clinical pathway.

Author (s): 

J. G. Maestro, M. Mapue II, J. Lopez, E. Tayag

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