Research Data Analyst Department of Pediatrics La Jolla, California, United States
Background: Epidemiological and immunological features suggest that Kawasaki disease’s etiology involves an immune reaction to an inhaled aerosol. Past studies have provided evidence for a relationship between certain wind patterns and increased incidence rates of Kawasaki disease, suggesting the long-distance transport of an aerosolized triggering agent. Recent analysis has improved our understanding of the age-dependence of KD’s epidemiological characteristics in Japan, wherein temporal and spatial variations of certain age groups exhibit epidemiological features that are likely explained by an environmental mechanism, which is consistent with a wind-blown etiology theory. Here we revisit this theory, investigating whether long-distance wind transport has a causative role in triggering KD. In doing so, we aim to develop our understanding of specific features of atmospheric transport that influence the incidence rate of KD.
Methods:
Using Japan’s extensive record of KD cases and state-of-the-art atmospheric modeling software and data, we analyzed the relationship between the timeseries of KD case rates and modeled wind back-trajectories for five major metropolitan regions across multiple scales of spatiotemporal variability, focusing on the 2010-2019 period.
Results:
We found a strong correlation between season-specific wind variables and subsequent variability in incidence rates of KD. Year-to-year fluctuations in wind measures offer a possible environmental explanation for the 2016-2017 significant decline in KD incidence in older children relative to the 2014-2015 period.
Conclusions:
These results provide strong new evidence that an environmental factor plays a causative role in triggering KD. The wind-KD relationship provides an avenue to understand the time and spatial scales at which environmental exposure may cause KD, helping narrow the search for etiological agents.
