Spatial and temporal clustering of Kawasaki syndrome cases.
Spatial and temporal clustering of Kawasaki syndrome cases.
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DOI：
10.1097/inf.0b013e31817acf4f
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发表时间：
2008-11
期刊：
影响因子：
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通讯作者：
Burns JC
中科院分区：
文献类型：
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作者：
Kao AS;Getis A;Brodine S;Burns JC
川崎综合征（KS）的病因仍然不明，尽管30年的密集搜索代理。可能的传染性病因学的流行病学线索包括病例的季节性分布、先前的流行病发生、与儿童中的其他传染性皮疹/发热疾病相似的综合征的临床特征、疾病的自限性以及幼儿年龄的高峰发病率。我们研究了1998年至2003年6年期间加州圣地亚哥县KS病例的流行病学以及时空分布。空间和时间上的聚类分析使用地理参考数据与K-函数，局部G-统计量，和诺克斯统计。通过积极监测共确定了318名患者。5岁以下儿童的总体年发病率为21.7/100，000，白人、白色西班牙裔和亚洲/太平洋岛民的发病率分别为15.3/100，000、20.2/100，000和45.9/100，000。Knox检验显示病例在3 km和3-5天的时空间隔内具有显著的聚集性。这是第一次研究KS案件使用地理参考点模式分析，以检测KS案件的空间和时间聚类。这些数据表明，感染因子触发KS的免疫级联反应。
The etiology of Kawasaki syndrome (KS) remains unknown despite 30 years of intensive search for an agent. Epidemiologic clues to a possible infectious etiology include the seasonal distribution of cases, the previous occurrence of epidemics, the clinical features of the syndrome that mimic other infectious rash/fever illnesses in children, the self-limited nature of the illness, and the peak age incidence in the toddler years. We examined the epidemiology and spatial and temporal distribution of KS cases in San Diego County, California during the 6-year period from 1998 to 2003. Clustering in space and time was analyzed using geo-referenced data with the K-function, the local G-statistic, and Knox statistic. A total of 318 patients were identified through active surveillance. The overall annual incidence was 21.7/100,000 in children <5 years, with rates in whites, white Hispanics, and Asian/Pacific Islanders of 15.3, 20.2, and 45.9/100,000, respectively. The Knox test showed significant clustering of cases within the space-time interval of 3 km and 3–5 days. This is the first study of KS cases to use geo-referenced point pattern analysis to detect spatial and temporal clustering of KS cases. These data suggest that an infectious agent triggers the immunologic cascade of KS.