"Our Kawasaki Disease scare": A Singaporean Mum's Story
This mum wants to share her story with everyone to create awareness about this disease.
It was an ordinary Friday morning when I saw my hubby with a thermometer in his hands. “Why? Is he (Rayden) running a temperature?”
“I think so. He feels warm.” My hubby replied.
I wasn’t too alarmed because this has happened too many times. The strange thing about Rayden’s body is he usually shows no signs and symptoms prior a fever. He was so energetic the previous night and who would have known that he will drop us a “bomb” this morning. Anyway, I was confident that he would recover in no time with lots of rest at home.
His temperature started climbing, hovering around 39.5 degrees. We gave him Panadol and Brufen every 3 hourly and sponged him to bring his temperature down.
It was a tough fight as his temperature would start to spike at the end of the 3 hour interval and once it even reached 40.8 deg. His energy was low and did not have much appetite. What disturbed me more were his sore eyes. This time it was just … different.
Rayden’s fever did not subside at Day 5 and I urged my hubby to bring him to hospital for a blood test. I was worried that he might have Kawasaki’s Disease (KD).
The blood test result showed that he had high inflammation level and needed to be admitted for observation and a heart scan because the doctors suspected he might have KD. My heart sank when I heard the news and started praying for this little boy.
What is Kawasaki Disease?
Kawasaki Disease was described by Dr Kawasaki in Japan in the 1960s and is an inflammation of the arteries of the body – probably triggered by a virus infection.
The danger in the disease is that the inflammation can cause damage to the coronary arteries and affect the heart muscle.
Signs and Symptoms
a persistent fever that is higher than 39 degrees
severe redness in the eyes
a rash on the child’s stomach, chest and genitals
red, dry, cracked lips
swollen tongue with a white coating and big red bumps
sore irritated throat
swollen palms of the hands and soles of the feet with a purple-red color
swollen lymph nodes
BCG scar may be prominent
Diagnosis and Treatment
If Kawasaki disease is suspected, a doctor may order tests to monitor the child’s heart function, which include an echocardiogram and other tests of heart function.
Usually, if Kawasaki disease is treated within 10 days of when the first symptoms begin, no heart problems develop. But if the illness goes untreated, it can lead to more serious complications that involve the child’s heart.
As Rayden was not showing all the symptoms of KD, (he had high fever, dry chapped lips, sore eyes and a bit of swollen lymph nodes) the doctor advised that we observed him further to confirm his condition before starting treatment.
She reassured us that as long as treatment starts within the window period of 10 days (I really do not know why), he will be fine.
We trusted the doctor’s professional judgement and decided to wait for one more day. And thank God the next morning, Rayden’s fever subsided and no other symptoms of KD appeared! He was well on his way to recovery.
Because of this experience, I would really like to do my part to raise awareness of Kawasaki Disease because I realize some people have not even heard about it!
An interview with Jeslyn Kang, whose son Matthias was diagnosed with Kawasaki Disease
Kaisin (K): How did you find out that Matthias had Kawasaki Disease?
Jeslyn (J): Matthias had persistent high fever and was admitted to KK Hospital. Even after being administered antibiotics, his fever showed no signs of waning. In fact, his condition kept deteriorating. He just kept sleeping the days away. The doctors said he had contracted an adenovirus that infected his lungs.
I remember sitting on the fold-out bed in the wee hours in the morning. Feeling tired but unable to sleep because I was so worried, I googled “persistent high fever” and chanced upon Kawasaki Disease.
When the consultant came by in the morning, I asked him if it could be Kawasaki’s Disease. I remember holding my breath as I waited for his reply. He replied,”Actually we are also thinking whether if it’s KD.”
They asked a rheumatologist to come by shortly after. She immediately scheduled Matthias for a heart scan. The heart scan would show whether the blood vessels have been dilated and they were. Based on this they concluded he had KD and IVIG treatment commenced that night.
Unfortunately he did not respond well to the treatment and his fever did not subside. It was another few days later when they gave a second dose that his fever finally went away.
K: Prior to this experience, did you know anything about Kawasaki’s Disease?
J: I have heard of KD, but never read up about it as it sounded like such an “exotic” illness.
The doctors in KKH told me that it is actually fairly common in Singapore. And after reading my FB posts, some friends also shared that their cousin’s children or friends’ children actually got it before too.
K: What was the treatment like and were there any side effects?
J: IVIG treatment is the antibodies of 1000 adults extracted from their donated blood. Administered over a few hours via IV drip. If there were any allergic reaction it would be quite immediate. IVIG is generally harmless and has no side effects. Usually for KD patients, fever would subside almost immediately after treatment.
K: What advice would you offer to parents about KD?
J: Do not brush off a fever. Look out for the symptoms of KD, which may include sore eyes, cracked and bleeding lips, strawberry tongue, persistent fever for more than 5 days, rashes, swollen lymph nodes and swollen hands and feet.
A person does not need to have all symptoms present to have KD. There is no conclusive test to tell whether a person has KD. Usually a heart scan would be most telling.
For Matthias he was lucky because his blood vessels were merely dilated and no aneurysms had formed. An aneurysm can cause a heart attack even in a baby if it bursts.
There is a treatment window period of 10 days for KD, starting from the first day the symptoms first appeared. This window is critical to ensure the aneurysms do not form. Matthias was given IVIG on day 8.
Buy a hospitalization plan for your child, as IVIG treatment is costly (about $900 per treatment under KKH class B2+). You would not want to be burdened by the medical fees at a stressful time like this. Hospitalization plan is a worthy investment to safeguard your child and your finances.
Be vigilant parents, sometimes it just takes our parental instincts to save our children. Visit https://www.nuh.com.sg/ktp-nucmi/clinical-care/disease-and-conditions/heart/kawasakis-disease.html for more details on Kawasaki Disease.