A new science advisory from the American Heart Association, published today in the Journal of the American Heart Association, stresses that international collaboration is key to reducing the risk of serious heart conditions in children with Kawasaki disease worldwide. The advisory highlights that while Kawasaki disease is highly treatable, many children face delayed diagnosis or limited access to care, especially in less-resourced regions.
Kawasaki disease is a rare but serious illness that primarily affects children under five years old. It causes inflammation of blood vessels, particularly the coronary arteries, and is the leading cause of acquired heart disease in children in developed countries. Symptoms include fever, rash, red lips, and “strawberry tongue.” Prompt treatment is critical to prevent progression to coronary artery aneurysms and other cardiovascular complications.
“Kawasaki disease is highly treatable, yet too many children around the world face delayed diagnosis or limited access to care,” said Ashraf S. Harahsheh, M.D., FAHA, chair of the advisory writing group and director of the Kawasaki Disease Program at Children’s National Hospital in Washington, D.C. “This science advisory underscores the power of international collaboration to advance research and improve care for patients everywhere.”
According to the advisory, delayed diagnosis remains a major barrier, particularly in countries with fewer health resources. If left untreated, approximately one in four children may develop coronary artery aneurysms. Prompt treatment with intravenous immunoglobulin (IVIG) reduces that risk to less than 5%. Strengthening diagnostic and treatment capacity in regions with limited access is essential.
The advisory notes that advances in Kawasaki disease management have been most successful in large, experienced, and economically advanced countries, often driven by strong research collaborations. However, most current collaborative networks lack formal funding. The advisory calls for inclusive international collaborations that consider cultural needs, prioritize reducing barriers to care, monitor outcomes, and promote evidence-based care, especially in low- and middle-income countries (LMICs).
An estimated 4,200 children are diagnosed with Kawasaki disease in the U.S. each year, but the disease occurs 10-30 times more often in East Asian countries like Japan, South Korea, China, and Taiwan, according to a 2024 American Heart Association scientific statement.
“When hospitals and health systems work together and compare how well they are doing, it can help identify local or regional challenges,” Harahsheh said. “Future international efforts should focus on working together to improve quality, building local expertise, mentoring clinical leaders, and strengthening care systems in LMICs.”
The advisory was prepared by the American Heart Association’s Rheumatic Fever, Endocarditis, Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young. It does not make treatment recommendations but informs the development of scientific statements and guidelines.
For more information, view the manuscript online.
