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Race-Specific Incidence Rates and Residential Proximity to Water

Robert L. Davis, MD, MPH; Patti L. Waller, MS; Beth A. Mueller, DrPH; Clare A. Dykewicz, MD, MPH; Lawrence B. Schonberger, MD, MPH

Arch Pediatr Adolesc Med. 1995;149(1):66-69.

Abstract
Objectives
To calculate race-specific incidence rates of Kawasaki syndrome (KS) and to assess the association of KS with residential proximity to water in Washington State.

Design
Incidence study over 4 years, using cases identified with a new statewide hospital data set and a casecontrol study.

Setting
King, Pierce, and Snohomish counties in Washington State.

Patients
One hundred twelve population-based incident cases meeting Centers for Disease Control and Prevention criteria for KS.

Main Outcome Measures
Race-specific KS incidence rates and distance to permanent bodies of water among KS cases and matched controls.

Results
For the years 1985 through 1986 and 1987 through 1989, the annual KS incidence rates were 6.5 and 15.2 per 100 000 children younger than 5 years, respectively. Rates were highest among Asian Americans (33.3 per 100 000 children younger than 5 years in the 1987-1989 period), followed by blacks and whites (23.4 and 12.7 per 100 000 children younger than 5 years, respectively). The median distance to water did not differ between cases and controls and the proportion of cases living within 150 yd (135 m) of water was no greater than that of controls (odds ratio, 1.0; 95% confidence interval, 0.1 to 20.9).

Conclusions
With complete ascertainment of incident-hospitalized cases of KS, the race-specific rates are among the highest documented in the United States. The rate among Asian Americans was less than that found in Japan, perhaps due to differences in environmental exposures or variations in susceptilbility among different Asian ethnic groups. Although we found no association with permanent bodies of water, future studies of KS should include home inspection to assess exposure to temporary collections of standing water.

(Arch Pediatr Adolesc Med. 1995;149:66-69)

Author Affiliations
From the Department of Pediatrics, University of Washington Medical Center (Dr Davis), Office of Epidemiology, Washington State Department of Health (Ms Waller), the Department of Epidemiology, University of Washington Medical Center and Division of Public Health Sciences, Fred Hutchinson Cancer Research Center (Dr Mueller), Seattle; and the Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Dykewicz and Schonberger).

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