(Photo Above: "Strawberry Tongue" can result from Kawasaki Disease)
In winter break of 2011, my friend was diagnosed with a disease that could have ended his life. I was at his house when he started to get sick. We had plans to go out later in the evening, so we spent the afternoon watching TV. All seemed well. However as it got later, I noticed Jared’s eyes becoming bloodshot and his tongue turning bright red. I asked him if he was feeling alright, and he admitted that he wasn’t. I ended up having to cancel our plans for later that night because Jared had “a cold,” so I went home. The next morning, I called Jared to see if he was feeling any better. His mom answered the phone, and told me that she had taken Jared to the emergency room late last night. He had been diagnosed with Kawasaki Disease (KD), or mucocutaneous lymph node syndrome.
That was the first time I had heard of “Kawasaki Disease.” I learned the basics from Jared’s mother; it is a disease that affects infants and children, she told me. It causes inflammation of the blood vessels in the heart, and in extreme cases, this inflammation can build up so much pressure that the vessel is left with a permanent bulge. This is called an aneurysm. She also told me that the cause of Kawasaki’s is unknown, and it has no cure. Jared was lucky; he received intravenous immunoglobulin (IVIG) and Remicade (a drug used for arthritis and Crohn’s disease) very quickly. The combination of these two drugs was enough to bring his fever down, and prevent any aneurysms. He has no long term side effects, but many others are not as lucky. Roughly 20% of Kawasaki’s patients have long-term cardiovascular problems, including heart failure in their thirties. Essentially, this means that for this 20% of patients, the disease never subsides. (Photo Right -- Wikipedia: X-ray showing aneurysmal enlargement of the coronary arteries, which is a complication in a Kawasaki syndrome)
One of the main reasons Jared was treated so quickly is that the leading Kawasaki’s doctor in the United States, Dr. Jane Burns, is based in UCSD. She has been studying Kawasaki disease for decades, but over the last few years, she and her team have made significant steps in identifying the cause and cure of this disease. The current hypothesis for the cause of Kawasaki’s is both surprising and fascinating.
Along with Japan and Hawaii, Southern California is a major hotspot for Kawasaki Disease. Because all of these hotspots are situated on the Pacific Ocean, researchers have questioned its role in the disease. Current researchers have hypothesized that the organism causing KD may come from Asia, meaning it can survive a trans-pacific crossing. To begin testing this hypothesis, researchers recorded and plotted wind patterns during KD outbreaks, lasting three to four days. They found that the tropospheric winds traveling from Japan to Hawaii to Southern California all originate from the Heilongjiang and Jilin provinces in Northern China. This gave Dr. Burns and her team a specific location where they could try to detect this elusive organism.
The next step was for the team to take a plane up into the troposphere and collect samples of the air above these northern Chinese provinces. What they discovered was groundbreaking. High levels of the yeast Candida were present in these samples. This was the first time in history that Candida was found in an airborne sampling over Asia. Dr. Burns and her team hypothesized that when northern Chinese agriculture is burned (either on a farm or in a powerplant), Candida yeast travels up into the troposphere with the smoke.
Back in the lab, researchers devised an experiment in which they exposed mice to the polysaccharides present in Candida. The mice developed symptoms very similar to those of Kawasaki Disease. The mice also responded positively to the immunosuppressive methods that doctors use to treat KD in humans. Although nothing can be said for sure yet, Candida seems to play a role in the cause of Kawasaki Disease. Once the cause is identified, finding a cure will be a far more manageable task.