Quick answer: Kawasaki disease is an uncommon childhood illness that causes inflammation of blood vessels throughout the body. It mainly affects young children and is more common in children of Asian descent, so awareness matters in Singapore. The key warning is a persistent high fever that does not settle with usual fever medicines, together with features such as red eyes, a rash, red cracked lips and swollen hands and feet. Early hospital treatment protects the heart, and most children recover well.
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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.
Red flags — see a doctor promptly: A young child with a high fever lasting several days that will not settle, especially with red eyes, a rash, red cracked lips, or red and swollen hands and feet, should be seen by a doctor without delay. Kawasaki disease needs early treatment to protect the heart. Call 995 or go to A&E if your child is very unwell, drowsy, floppy or breathless.
Every parent knows the anxiety of a child with a fever that simply will not break. Most childhood fevers are caused by ordinary infections and settle on their own. Occasionally, though, a lasting fever with a particular cluster of signs points to something less common that needs urgent attention. Kawasaki disease is one of these. It is not contagious and cannot be caught from another child, but it is important because, left untreated, it can affect the heart. Recognising it early gives a child the best chance of a full recovery.
What Kawasaki disease is
Kawasaki disease is an uncommon illness, mainly of young children, in which blood vessels throughout the body become inflamed. This inflammation is what produces the fever, rash, red eyes and other visible changes. It matters most because, if it is not treated promptly, it can affect the coronary arteries — the small blood vessels that supply the heart muscle. Inflammation there can weaken or widen the artery wall, which is the main reason doctors treat the illness quickly.
The condition is more common in children of East and Southeast Asian descent than in other groups. Because Singapore’s population includes many children of Asian background, it is seen here more often than in some other parts of the world, and local paediatricians are familiar with it. The reassuring message is that most children who are diagnosed and treated early recover well.
Symptoms to look for
The central feature is a persistent high fever that does not settle with the usual fever medicines and lasts several days. Alongside the fever, a child will usually show several of the following:
- A rash over the body
- Red eyes without any discharge or stickiness
- Red, cracked lips and a bumpy red “strawberry” tongue
- Swollen, red hands and feet, sometimes with peeling of the skin around the fingers and toes at a later stage
- A swollen gland in the neck, often on one side
Children with Kawasaki disease are typically very irritable and clearly unwell — more miserable than a common cold or ordinary fever would explain. Not every child shows every sign, and the features may appear one after another rather than all at once, which can make the illness harder to recognise. This is why a fever that persists with any of these changes deserves a doctor’s assessment.
Why prompt treatment matters
The reason doctors act quickly is to protect the heart. The inflammation of Kawasaki disease can involve the coronary arteries, and starting treatment early greatly reduces the chance of these complications developing. When a child is treated in good time, the risk of lasting heart problems is much lower. When treatment is delayed, the coronary arteries are more likely to be affected. Prompt care is therefore not about the fever itself but about preventing harm to the heart later.
Causes and who is at risk
The exact cause of Kawasaki disease is not fully known. It is thought to involve the immune system reacting strongly, possibly triggered by an infection in a child who is predisposed, but no single germ has been identified as the cause. It is not passed from person to person, and nothing a parent did or did not do brings it on.
It occurs mainly in young children. It is more common in children of East and Southeast Asian descent, which is one reason awareness is particularly relevant in Singapore. Boys are affected slightly more often than girls. Because the illness cannot be prevented, the most useful thing families can do is recognise the pattern and seek care early.
How it is diagnosed
There is no single test that confirms Kawasaki disease. A paediatrician makes the diagnosis by recognising the pattern of a persistent fever together with the characteristic features, and by ruling out other causes of a prolonged fever. Blood tests are used to look for signs of inflammation in the body and to help exclude other illnesses. An echocardiogram — an ultrasound scan of the heart — is done to look closely at the coronary arteries and check whether they have been affected.
Because the features can come and go, and because some children have only some of them, diagnosis can be challenging. Doctors at hospitals such as KK Women’s and Children’s Hospital (KKH) and the National University Hospital (NUH) assess children carefully and may keep a child under observation while the picture becomes clearer.
Treatment
Kawasaki disease is treated in hospital under specialist supervision. The main treatment is a medicine given into a vein called immunoglobulin, which calms the inflammation and lowers the risk of heart complications. Children are also given aspirin as part of treatment.
It is worth noting that aspirin is used here specifically under medical direction. Parents are usually advised not to give aspirin to children for ordinary fevers, but in Kawasaki disease it is prescribed deliberately by the specialist team as part of the treatment plan. Never start or stop it on your own — follow the paediatrician’s instructions. After treatment, children have follow-up heart scans to check how the coronary arteries are recovering.
Recovery and follow-up
Most children treated early for Kawasaki disease recover fully and go on to be perfectly well. The fever usually settles once treatment begins, and the visible signs fade over the following period, sometimes with peeling of the skin on the hands and feet as things resolve.
Some children need ongoing follow-up with a heart specialist, particularly if the coronary arteries showed any changes. This may involve repeat echocardiograms and, in a small number of children, continued medicine and longer-term monitoring. The paediatric and cardiology teams will explain what follow-up your child needs and for how long.
When to seek urgent help
Take your child to a doctor promptly if they have a high fever that lasts several days and will not settle with the usual fever medicines, especially if you also notice red eyes, a rash, red cracked lips, or red and swollen hands and feet. These together should be assessed without delay.
Call 995 or go straight to A&E if your child is very unwell, drowsy, floppy, difficult to wake, breathless, or if you are seriously worried about how they look. Trust your instincts — you know your child best, and it is always better to have them checked.
Common questions
Is Kawasaki disease contagious?
No. It cannot be caught from or passed to another child. Siblings and classmates are not at risk from an affected child.
Will my child’s heart be permanently damaged?
Most children treated early recover fully with no lasting heart problems. Early treatment is what makes the biggest difference, which is why prompt care matters.
Why is aspirin used when I was told never to give it to children?
In Kawasaki disease, aspirin is prescribed on purpose by the specialist team as part of treatment. That is different from giving it yourself for an everyday fever. Always follow the doctor’s instructions.
Can Kawasaki disease come back?
It is uncommon for it to return, but not impossible. If your child develops a similar lasting fever with the same features again, seek medical assessment.
My child had a fever for a couple of days — should I panic?
Short fevers from common infections are usual and not a cause for alarm. It is a fever that persists over several days, together with the features described above, that should be checked by a doctor.
Related guides
Sources
- KK Women’s and Children’s Hospital (KKH)
- HealthHub
- American Heart Association
- NHS
Disclaimer: This guide is for general information only and is not a substitute for professional medical advice. It cannot diagnose your child. If you are worried about your child’s health, please see a paediatrician or go to A&E. In an emergency, call 995.