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Rising Kawasaki disease incidence in New Zealand: analysis of national population incidence and outcomes 2000–2017
  1. Paul Gee1,2,
  2. David Burgner3,4,
  3. Waverley Gee5,
  4. Angela Forbes6,
  5. Christopher M A Frampton6,
  6. Andrew McCombie2
  1. 1 Emergency Medicine, Christchurch Hospital Te Whata Ora, Christchurch, New Zealand
  2. 2 Department of Surgery and Critical Care, University of Otago, Christchurch School of Medicine, Christchurch, New Zealand
  3. 3 Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  4. 4 Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
  5. 5 Department of Radiology, Auckland City Hospital, Auckland, New Zealand
  6. 6 Department of Medicine, University of Otago, Christchurch, New Zealand
  1. Correspondence to Dr Paul Gee, Emergency Medicine, Christchurch Hospital, Christchurch 8011, New Zealand; paul.gee{at}


Objective The recent epidemiology of Kawasaki disease (KD) in New Zealand (NZ) is unknown. Our aim was to describe the incidence, seasonal variation, long-term outcomes and mortality for KD in NZ.

Design Retrospective national database analysis.

Setting New Zealand.

Patients First hospitalisation and deaths diagnosed with KD.

Main outcome measures Data were extracted for all hospital admissions in NZ coded as KD (International Classification of Diseases (ICD)-9 and ICD-10) from the National Minimum Dataset 1 January 2000 to 31 December 2017. Age, sex, ethnicity and associated diagnoses were available to review. Intervention rates for immunoglobulin administration were also analysed.

Results Over the study period, there were 1008 children with initial hospitalisation for KD. The mean age was 39.8 months (SD 37) and 592 (59%) were boys. The annual incidence rate of KD has increased from 12.2 to 19.5 per 100 000 children <5 years old (0.46 case increase per year; 95% CI 0.09 to 0.83). Children of Asian and Pacific Island ethnicities had the highest incidence (51.2 and 26.1/100 000, respectively). The highest growth in incidence was among East Asian children. The case mortality rate was low (12 of 1008, 1.2%); however, Māori were over-represented (6 of 12 deaths).

Conclusions There is evidence of increasing KD hospitalisation in NZ, similar to recent studies from Northeast Asia and Australia. KD incidence data were available for retrospective review from a national database, but data on complications and outcomes were incomplete. Notification for KD and an active national surveillance system are recommended to improve care. Future work should focus on factors contributing to poorer outcomes in Māori.

  • Epidemiology

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Extracted and de-identified NMDS data available upon reasonable request from corresponding author.

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Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Extracted and de-identified NMDS data available upon reasonable request from corresponding author.

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  • Contributors PG and WG contributed to the conception, design and data collection. PG, DB and AM wrote the manuscript. AM, AF, CF and WG performed the data analysis and interpretation. All authors reviewed and advised on the content of the manuscript. PG is guarantor of the overall content of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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