ICS Magazine

Breaking the Kawasaki Syndrome Myth

June 13, 2000

I had a call recently from a cleaner who was scheduling a cleaning appointment for a client and was asked about Kawasaki Syndrome. A syndrome, as termed here, is actually a medical term that describes a set of symptoms and is usually named after the person who first documents the conditions or symptoms. In this case, it was first described by a Japanese pediatrician in 1961.

In the early 1990s, numerous media reports stated that carpet cleaning caused KS, a rare disease that usually strikes children under five years of age. It begins with a high fever that does not respond to traditional fever therapy. After the fever has begun, other symptoms begin to develop: the child’s eyes become red; their lips, mouth and throat become red and sore; and a red rash develops on the body. The Centers for Disease Control (CDC) case definition is as follows:

Fever lasting five days or more without other more reasonable explanation and at least four of the following criteria:

  • Bilateral conjunctivitis (red eyes)

    • Red/sore lips, mouth or throat, “strawberry” tongue

      • Red rash on body

        • Swollen, red, tender hands and feet with peeling skin

          • Lymphadenopathy (swollen glands) with one node (gland) 1.5 cm in diameter.

            The CDC estimates there are 1.1 cases of KS per 100,000 children under 5 annually. There is no evidence the disease is contagious and only 1% of children have a recurrence. Males are 1.5 times as likely as females to get KS. Asians and blacks have a higher incidence rate of KS than do whites. The disease seems to have seasonal peaks in spring and winter.

            There are some complications associated with KS. These include joint pain or swelling, enlarged liver or spleen and meningitis. The major complication of KS is coronary artery aneurysms (swelling of the arteries which supply blood to the heart muscle). Approximately 20% of KS patients develop this complication. In extremely rare cases (less than 1% of all KS cases), these aneurysms can result in a fatal heart attack.

            Carpet Cleaning and Kawasaki Syndrome

            Some medical researchers have reported an unexplained, weak but statistically significant correlation with prior carpet cleaning in the homes of some KS patients. Many other reports have shown no association between carpet cleaning and KS. This supposed “link” was first reported in a study of an outbreak in Colorado in 1982. Researchers found that children with KS were more likely than unaffected children to be exposed to rug/carpet “shampooing” within 30 days prior to becoming ill.

            Following these findings, the CDC conducted subsequent investigations of Kawasaki Syndrome outbreaks. Four of these investigations and studies conducted by the Maryland State Department of Health and Mental Hygiene and by investigators in eastern Ontario and western Quebec showed no association between Kawasaki Syndrome and carpet cleaning. In subsequent CDC investigations of KS cases in Houston (1984), Los Angeles (1985) and Denver (1984), significantly higher rates of carpet cleaning were reported by parents of KS patients than by parents of unaffected children.

            It’s important to note that none of these studies have been able to determine any precise relationship between carpet cleaning and Kawasaki Syndrome. No specific detergent or cleaning method has been identified as a cause of KS. In addition, many KS patients have not had exposure to carpet cleaning. Exposure to carpet cleaning is not a requirement for contracting KS. Researchers have found no explanation of the fact that some outbreaks are statistically associated with carpet cleaning while many others are not: “Despite more than 25 years of intensive investigation into the cause and treatment of this disease, epidemiological and laboratory studies have not yet identified an etiologic agent (an agent which causes the disease).”

            Carpet Cleaning

            The CDC fact sheet, “Kawasaki Syndrome and Rug Cleaning” recommends the following: “... parents should keep in mind that KS is a rare disease. Rug cleaning, in contrast, is very common. In a survey of parents of young children in Colorado, 91% had cleaned their rugs (or had them cleaned professionally) at least once during the preceding two years.

            Thus, while thousands of children were exposed to the use of rug shampoo (or a steam extraction method of cleaning), only a tiny fraction came down with KS. Therefore, risk appears to be extremely small. Secondly, no one brand of shampoo or method of cleaning has been associated with Kawasaki syndrome than another, although most parents of children with KS applied the shampoo themselves.

            However, in one study, the researchers did find that children who eventually came down with KS were almost always in the room when the shampoo was applied, or came into the room within two hours—significantly earlier than children in the survey who were exposed to shampooed rugs but did not get KS. Thus, it might be prudent, as with any chemical exposure, to keep young children away from newly shampooed rugs for at least several hours.”

            It’s also important to note that not cleaning carpets may pose a greater health risk than cleaning them. Carpets are known to act as sinks for soils, bacteria, mold and fungus. If these soils are not removed through periodic professional cleanings, they may contribute to indoor air quality problems and possible health problems for occupants.

            Note that the CDC fact sheet prudently recommends that children be kept away from and off of freshly cleaned carpets for eight to twelve hours, preferably longer, at least until they are thoroughly dry. In extreme cases, this might take as long as 48 hours or more.

            If you would like more information on Kawasaki Syndrome, contact your local or state health department or write to the Centers for Disease Control in Atlanta, GA. Keep in mind preparedness it has become imperative when cleaning carpets. Keep accumulating information. Until next month, seeya!