A newly described virus is not a cause of Kawasaki disease, according to an article by a group of researchers in Denver, Colorado. Their article appears in the Dec. 15 issue of The Journal of Infectious Diseases, now available online.
The cause or causes of Kawasaki disease, an important pediatric infection that may lead to heart disease, have long been elusive. A study published in The Journal of Infectious Diseases last year by Jeffrey S. Kahn, MD, and colleagues at Yale University suggested that Kawasaki disease was associated with a new human coronavirus – one of a family of viruses affecting the respiratory tract. As an accompanying editorial pointed out then, the association required confirmation by other investigators.
Prompted by the Yale findings, Samuel R. Dominguez, MD, PhD, and colleagues at the University of Colorado Health Science Center and The Children's Hospital in Denver conducted a case-control study comparing nasopharyngeal samples of pediatric patients to determine if infection with the new human coronavirus, also called coronavirus NL63, is associated with Kawasaki disease. They found it was not: The percentage of children infected with coronavirus NL63 was the same--7.7 percent--in children both with and without Kawasaki syndrome,.
As to why the new results diverged from those of Dr. Kahn, Dominguez suggested one possibility could have been an inadvertent selection bias based on the samples available in the previous study. Of the 53 children identified with Kawasaki disease in the previous study, respiratory specimens were only available from 11 children.
Anne H. Rowley, MD, from Northwestern University Feinberg School of Medicine and The Children's Memorial Hospital in Chicago pointed out in an accompanying editorial other studies testing the association between coronaviruses and Kawasaki disease. The conclusions of these studies are similar to those of Dominguez et al, she said, and "it is now quite clear that the elusive etiological agent of Kawasaki disease is not the new human coronavirus."
Rowley commented that "finding the cause of Kawasaki disease is a pediatric infectious diseases research priority. Identification of the causative agent(s) would be the most promising step toward developing a diagnostic test and specific therapy, and ultimately preventing the disease."
Founded in 1904, The Journal of Infectious Diseases is the premier publication in the Western Hemisphere for original research on the pathogenesis, diagnosis, and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune mechanisms. Articles in JID include research results from microbiology, immunology, epidemiology, and related disciplines. JID is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Alexandria, Va., IDSA is a professional society representing 8,300 physicians and scientists who specialize in infectious diseases. For more information, visit www.idsociety.org.
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