A new science advisory from the American Heart Association, published today in the Journal of the American Heart Association, underscores the critical need for global collaboration to reduce the risk of serious heart conditions in children with Kawasaki disease. The advisory highlights that while Kawasaki disease is highly treatable, many children face delayed diagnosis or limited access to care, particularly in low- and middle-income countries (LMICs).
Kawasaki disease is a rare but serious illness that primarily affects children younger than five years old. It causes inflammation of blood vessels throughout the body, especially the coronary arteries, and is the leading cause of acquired heart disease in children in the U.S. Symptoms include fever, rash, red lips, and "strawberry tongue." Prompt treatment is critical to prevent serious cardiovascular complications, and most children recover fully with treatment. However, if left untreated, approximately one in four children may develop coronary artery aneurysm. Prompt treatment with intravenous immunoglobulin (IVIG) can reduce the risk of aneurysm to less than 5%.
According to the advisory, delayed diagnosis remains a major barrier to optimal outcomes, particularly in countries and communities with fewer health resources. Strengthening diagnostic and treatment capacity in these regions 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 and shared expertise. However, most current Kawasaki disease collaborative networks do not have formal funding.
The advisory calls for a global, harmonized approach that considers cultural needs, prioritizes uncovering barriers to care, monitors results to improve outcomes, and promotes evidence-based care across regions, especially in LMICs. Effective international collaboration must account for differences in culture, language, time zones, and available resources. Including patients, families, and advocacy groups is also important to support patient-centered care and improve access to 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," said Ashraf S. Harahsheh, M.D., FAHA, chair of the science advisory writing group and director of both the Kawasaki Disease Program and the Quality Outcomes in Cardiology Program for Children’s National Hospital in Washington, D.C. "Future international efforts should focus on working together to improve quality, building local expertise, mentoring clinical leaders, and strengthening care systems in low- and middle-income countries, where access to care is often most limited."
This science advisory was prepared by the volunteer writing group on behalf of 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 (the Young Hearts Council). The full manuscript is available online.
