Shaken Baby Syndrome

A large number of child deaths are reported in South Africa each year. A lot of deaths relate to neglect, abuse or murder. Despite this, there's a knowledge gap in relation to understanding the issue....

Amniotic fluid problems

The importance of amniotic fluid Amniotic fluid is essential for pregnancy and foetal development. Amniotic fluid is a watery substances residing inside a casing called the amniotic membrane or sac. ...

Choosing a pre-school

Becoming a parent is a momentous; life-changing event filled with hopes, expectations and naturally some fears. Parents often learn and grow alongside their children, as they face the challenges of pa...

Newborn reflexes

Although newborn babies are physically helpless and vulnerable at birth, they have a number of amazing innate abilities or reflexes. Reflexes are involuntary movements or actions, designed to protect ...

Mastitis

Mastitis is an inflammation of the breast that can lead to infection. The word “mastitis” is derived from the Greek word “mastos” meaning “breasts”, while the suffix “-itis” denotes “inflammation”. Ma...

Pelvic floor exercises

Although your new baby will probably bring you immense emotional satisfaction, physically you may feel uncomfortable and strange in your own skin. After 9 months of pregnancy and hormonal changes, you...

Colic

Babies cry because they need to communicate something and most parents, especially new moms, find it distressing to see or hear an unhappy baby. In time, you will learn to recognize the various causes...

Antenatal Classes

Antenatal classes are informative sessions provided to prepare expecting parents for the birth of their child and the early days of being a parent.Most antenatal classes are run by Midwives and occasi...

Strap-in-the-Future

The Decade of Action for Road Safety 2011-2020 was launched on the 11 May 2011. It is a global declaration of war against road crashes and fatalities. According to Mr Sibusiso Ndebele, MP Minister of ...

  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Kawasaki Disease

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an illness of unknown origin that affects the skin, mouth and lymph nodes. It is most common in children of Japanese and Korean descent, under the age of 5, but it can affect all ethnic groups. It occurs in boys twice as often as it does in girls. Early recognition of symptoms is associated with a full recovery within a few days but if left untreated, serious complications, involving the heart, can ensue (Lucile Packard Children's Hospital, 2011; The Nemours Foundation, 1995-2011).

Symptoms:

The symptoms of Kawasaki disease usually occur in phases:

1. Phase 1, which can last for up to 2 weeks, is characterized by a persistently high fever (39*C) that lasts for at least 5 days. Other signs and symptoms include;

Severely red and inflamed eyes, with no discharge

  • A rash appearing primarily on the stomach, chest and abdomen
  • Red, dry, cracked lips
  • A swollen tongue with a white coating and big, red bumps- a condition known as 'strawberry tongue'
  • Sore, irritated throat
  • The palms of the hands and the soles of the feet become swollen (edema) and purple-red in colour
  • Swollen lymph nodes in the neck area

(All Mother's: Pregnancy & Parenting, 2011; The Nemours Foundation, 1995-2011).

2. Phase 2, generally begins 2 weeks after the onset of the fever and may include;

  • Peeling of the skin on the hands and feet
  •  Irritability
  •  Joint pain
  •  Diarrhoea
  •  Vomiting
  •  Abdominal pain

(The Nemours Foundation, 1995-2011).

Complications:

Since Kawasaki disease is the most common form of vasculitis primarily affecting children, the main threat from the disease comes from its effects on the heart and blood vessels. Short or long term heart related complications can begin as early as 2 weeks after the onset of the disease. 1 in 5 children may develop heart complications, particularly those involving the coronary arteries. Infants of less than 1 year are especially at risk for cardiac involvement and are the most severely ill. The risk of developing coronary heart disease later in life is still unknown (Lucile Packard Children's Hospital, 2011).

The coronary arteries are responsible for supplying the heart with an oxygen-rich blood supply. Kawasaki disease can weaken the wall of 1 or more of these arteries, causing them to bulge or balloon out. This weakened, ballooned area is known as an aneurysm. On rare occasions, this aneurysm can burst. Blood clots can also form in this ballooned area, blocking off the supply of blood from the coronary artery to the heart, possibly causing damage to the heart muscle. The illness may also be responsible for the irritation and inflammation of the heart muscle (myocardium) and the membrane covering the heart (pericardium). Irregular heart beat and heart valve problems may occur (Lucile Packard Children's Hospital, 2011; News-Medical.net).

Diagnosis:

There is no specific test to diagnose Kawasaki disease. A prolonged fever (5 days) of unknown origin together with some of the above symptoms, will alert your physician to consider Kawasaki disease. To confirm a diagnosis or to eliminate other conditions that have similar nonspecific symptoms, e.g. scarlet fever, your doctor may order blood tests. These tests are used to detect mild anemia, an elevated white blood cell count and an elevated sedimentation rate (ESR), that indicates inflammation. Blood tests also indicate an increase in platelets and a major clotting element in the blood. Your doctor may require a urine sample to check for the presence of protein and white blood cells. An echocardiogram may be used to assess if there is any damage to the heart or the coronary arteries and an Electrocardiogram (ECG) checks for any abnormal heart rhythms (American Heart Association, 2011; Cincinnati Children's Hospital Medical Centre, 1999-2011).

Treatment:

The main line of treatment for Kawasaki disease is to give intravenous immunoglobulin or gamma globulin which is prepared from the antibody fraction of healthy donors. Intravenous immunoglobulin is very safe and once your child has been on a drip for several hours, they are usually better the next day. Aspirin is usually given simultaneously to reduce inflammation and to prevent clots from forming. Aspirin is not usually recommended for children due to its association with Reye's syndrome, but Kawasaki disease is one of the exceptions to the general rule. Fever reduction and increasing fluids are very helpful. Occasionally despite early treatment, some children will still develop heart problems and will need to see a children's cardiologist for several years (Children's Hospital at Westmead, 2010; News-Medical.Net).

Prevention:

Since the cause of Kawasaki disease is currently unknown, there is no way of preventing a child from getting the disease. It is thought that the illness is a severe response to an infection but the responsible organism has not been identified. Research is being done to discover more about the disease, its causes, treatment and prevention. Once a child has had Kawasaki disease, it is rare for them to contract it again. Kawasaki disease is also not highly contagious. If a child gets Kawasaki disease, it is very rare for their siblings to contract the illness. There also does not appear to be a genetic basis (Children's Hospital at Westmead, 2010).