International Collaboration Crucial to Reduce Heart Risks in Children with Kawasaki Disease, New Science Advisory Says

A new science advisory from the American Heart Association emphasizes that international collaboration in research, diagnosis, and care is essential to reduce the risk of serious heart conditions for children with Kawasaki disease worldwide. Published today in the Journal of the American Heart Association, the advisory calls for a harmonized global approach to address disparities in diagnosis and treatment, particularly in low- and middle-income countries (LMICs).

Kawasaki disease is a rare but serious illness primarily affecting children under five, causing inflammation of blood vessels, especially the coronary arteries. It is the leading cause of acquired heart disease in children in developed countries. Symptoms include fever, rash, red lips, and “strawberry tongue.” Prompt treatment with intravenous immunoglobulin (IVIG) can reduce the risk of coronary artery aneurysm from about 25% to less than 5%. However, delayed diagnosis remains a major barrier, especially in regions with limited health resources.

“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.”

Although the cause of Kawasaki disease remains unknown, it is suspected to be an abnormal immune response to a trigger in genetically susceptible children. The disease occurs 10 to 30 times more often in East Asian countries such as Japan, South Korea, China, and Taiwan, according to a 2024 American Heart Association scientific statement. In the U.S., more than 4,200 children are diagnosed each year.

The advisory highlights that advances in Kawasaki disease management have been most successful in large, economically advanced countries, driven by strong research collaborations and shared expertise. However, most current collaborative networks lack formal funding. The advisory calls for inclusive international collaborations that consider cultural needs, reduce barriers to care, and promote evidence-based treatment, particularly in LMICs. Including patients, families, and advocacy groups is also crucial for patient-centered care.

“When hospitals and health systems work together and compare how well they are doing, it can help identify local or regional challenges—such as gaps in resources or access to care—that need to be addressed,” Harahsheh said. Future efforts should focus on improving quality, building local expertise, 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.

Additional resources from the American Heart Association include a 2024 scientific statement on early detection and treatment, and a 2021 news release on pandemic prevention measures linked to lower rates of the disease.

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