Are there any precautions I need to take after my child has recovered from Kawasaki Disease?

I’m glad to hear that your child has recovered well.

Short answer:

1. The good news is that most children treated for Kawasaki disease recover fully with no long term complications, and will not need further treatment.
2. The earlier he was treated, the better.
3. Recurrence of Kawasaki disease is uncommon.
4. He should, however, continue to follow a healthy diet, and adopt healthy lifestyle habits to reduce the risk of future heart disease (this applies to all children, not just those who have Kawasaki disease).

The main long term complication is cardiovascular complications – You may have been informed that your child will be followed up with a heart scan (2-D echocardiography), which will be repeated 3 months later.

The reason for this is because Kawasaki disease is due to inflammation of blood vessels, and can sometimes affect important blood vessels around the heart. Again, the chances of this are low if your child was treated early on.

Only about 5% children with Kawasaki go on to develop cardiovascular complications, mainly in those who received delayed treatment.

I know that you probably have a lot of questions and concerns, so I’ll attempt to provide as comprehensive an answer as I can below, bearing in mind that this is general information for children who have recovered from Kawasaki Disease, and is not a substitute for medical advice from the PD following up with your child.

What can you expect after discharge:

1. Your child might continue to show symptoms associated with Kawasaki disease for up to 6 weeks.
2. He may continue to be irritable for 2 – 3 weeks after discharge.
3. His appetite might take a long while to return to normal.
4. It’s common for the skin on his hands and feet to peel. This will heal with time. He may also experience skin sensitivity and skin peeling in other areas.

Follow up care after Kawaski Disease:

1. If your child has not been given his MMR and chicken pox vaccine yet, it will have to be delayed until 11 months after the IVIG was given. IVIG can prevent these vaccines from working properly.
2. Monitor for fevers. Upon discharge, it’s useful to continue monitoring his temperature, especially if you think that he feels hot or looks unwell. This should continue until your child’s next follow-up visit.
3. Apply moisturisers liberally on areas where his skin is peeling, such as on his hands and feet. Use lip balm if his lips are dry or cracking.
4. Try to get him to drink more water to prevent dehydration, especially if he has diarrhoea.
5. Give him more food that is high in fibre to prevent constipation.

Precautions after Kawaski Disease:

1. Physical activity wise, he should take it easy and avoid strenuous exercise for about 2 to 4 weeks, unless otherwise advised by your child’s cardiologist. In any case, it’s likely that he will not feel completely well for several weeks upon discharge, and therefore limit his own activity level.
2. Restrictions on physical activity thereafter are dependent upon the risk of myocardial infarction. The restrictions should be determined in consultation with your child’s cardiologist.
3. It’s probably best to avoid crowded places until his next follow-up appointment (and then check with your doctor on this).

Cheers