Kawasaki Disease Awareness/Knowledge

Investigators: What if It’s Not the Flu-Kawasaki Disease
MINNEAPOLIS - The H1N1 flu is everywhere. But are health care providers jumping the gun when diagnosing it? The FOX 9 Investigators profile the case of a little girl who's facing a lifetime of medical issues because, at first, everyone thought she had the flu.
Amira has a smile that will melt your heart. But for weeks the smile went away because she was miserably sick. Was she another victim of H1N1? By the time that question got answered the damage was done.
Amira’s mother knew something wasn’t right because her daughter was so fussy. “I thought maybe it was the flu."
Besides being hot to the touch her mother says parts of Amira's body had actually turned red. "You can look at her and tell like something wasn't right."
Miera Horton was worried it might be H1N1 which is hitting some young children especially hard. So she says she took Amira to the emergency room at Children's Hospital in Minneapolis.
Horton said, “She did have a fever at the time, it was like 102, so they told me to give her Tylenol every four hours and watch and the fever should go away in a few days."
Horton says the fever didn't go away. In fact three days after that visit to the ER she says Amira was burning up, her temperature was now a 105 degrees. She says they went back to Children's Hospital.
Horton said, “Her throat was really, really red, her eyes was really red, her mouth, her whole mouth was red so they swabbed her throat for a strep test."
Horton says the strep test was negative as was a test for a urinary infection. She says the doctor thought it was probably a seasonal flu and put Amira on a prescription of Tamiflu to treat it.
"They said follow up in the pediatric clinic within three to four days," said Horton.
Three days later, they were back at Children's clinic for the follow up. Horton says her daughter still had that strange redness all over.
“She was just so inflamed, her hands and her feet and her mouth, her lips were really, really cracked and bleeding."
On this visit, according to Horton, another doctor figured Amira was not suffering from the regular flu, but the H1N1 variety.
“They said it should run its course within 10 to 14 days." She said.
Several days passed, and Horton says Amira was even more miserable. She still had that redness and didn't want anyone touching her hands or feet.
“We would put her down so she could run around as soon as her feet would hit the floor she would just scream." Horton said.
Once again, Amira was taken back to Children’s, her fourth visit in over two weeks. This time there was a new diagnosis. It wasn’t H1N1 but something called Kawasaki disease, which if not caught within the first ten days, can cause permanent heart damage.
Horton said, “If you're a parent and you go in with a lot of symptoms and they tell you H1N1 don’t just accept that.”
Amira spent a week in the hospital. She was treated with blood thinners and other medications to bring down swelling in her coronary arteries which supply blood to the heart muscle.
"It can go back down but there will be scar tissue forever and that scar tissue can cause blood clots which could go to her heart and give her a heart attack, so she’ll pretty much be on blood thinners for the rest of her life." Horton said.
Horton gave the hospital permission to discuss Amira's case with the FOX 9 Investigators but a spokesman for Children's sent us an e-mail saying "We are not comfortable making comments specific to this patient even though the mother has approved."
Childrens’ went on to say it could only supply this statement:"If your child has flu-like symptoms it’s important to stay vigilant and to call your doctor if symptoms persist. These can be signs of a secondary infection or a different illness altogether."
Horton said, “It makes me very upset that it could have been diagnosed sooner.”
Kawasaki disease is rare. About 20 kids a year in Minnesota come down with it. No one knows what causes it but experts say it’s important to get treated within ten days after the high fevers begin.
Steve Swanson is a pediatrician with HCMC. He said, “In that time period if you can act and treat, you can reduce significantly the risk of any long term damage to the heart.”
Swanson says in its early stages Kawasaki might be confused with the flu.
“Although as time progresses there should be symptoms and physical findings in a child with Kawasaki disease that are very unique from the flu.”
Those symptoms include inflammation and redness around the mouth, hands or feet. Horton says those were the same symptoms Amira had each time she took her to Children's. “She’s weak and really doesn’t want to walk,” Horton said.
A week after being released from the hospital Amira was doing much better but her prognosis for the future is still uncertain.
Could her illness have been diagnosed earlier?

Without access to her medical records or the doctors who treated her one can only speculate. But with so much attention being given to the H1N1 flu, Dr. Swanson says

health professionals
have to be careful not to get tunnel vision.
“When you’ve seen six or seven people in your clinic who all have influenza like illness, the next person who comes in with fever and sore throat, you may falsely assume that this is influenza when in fact it may be something else.”
It may take a year before doctors know the true extent of damage to Amira's heart. Her family wants other parents to learn from their experience. If your child has flu-like symptoms, like a high fever or trouble breathing, it could mean something else is wrong. Call your doctor.