Dr. Tomisaku Kawasaki, who in 1967 first identified a disease in children that remains mysterious today and that has recently been in the news in relation to COVID-19, died June 5 in Tokyo. He was 95.
The illness, which produces inflammation around the heart and can be fatal, became known as Kawasaki disease. The Kawasaki Disease Foundation, which promotes education and research, posted news of Dr. Kawasaki’s death on its website.
Dr. Kawasaki was a pediatrician in a Tokyo hospital in 1961 when he examined a four-year-old boy who had a high fever, red eyes and a red rash, among other symptoms. He first thought the child had scarlet fever, which is caused by the same type of bacteria that causes strep throat, but a throat culture ruled that out. The next year, six more children turned up at the hospital with the symptoms.
“I asked another pediatrician, an old medical school teacher, had he ever experienced such cases?” Dr. Kawasaki told The San Diego Union-Tribune in 1991. “’No,’ he shook his head.”
Dr. Kawasaki continued to record cases and, in 1967, published a paper in a Japanese medical journal postulating that they represented a new disease, which he called “mucocutaneous lymph node syndrome.” But Kawasaki disease was the name that stuck.
In recent months, when children in New York and elsewhere began turning up with a multi-symptom inflammatory syndrome that researchers thought may have been linked to exposure to the novel coronavirus, the similarities to Kawasaki disease were quickly noted. At the moment, however, scientists believe that the virus is a distinct syndrome, not a version of what Dr. Kawasaki identified and spent his career studying.
Tomisaku Kawasaki was born Feb. 7, 1925, in Tokyo. He graduated from what is now the Chiba University School of Medicine in 1948 and began his pediatric training at what is now the Japanese Red Cross Medical Center in Tokyo.
He was more than a decade into his tenure when he encountered his first case of the previously unidentified syndrome. He was stumped.
“I thought about this case a lot,” he said in a 2012 interview with the journal Pediatric Annals. “For the next year, I didn’t see any similar case. But in February, 1962, I saw another patient and then realized that this was a unique clinical entity not in the textbooks.”
Soon he had five more cases. In October of that year, he presented a report on the first seven cases at a medical conference in Japan, but colleagues didn’t see the significance. “I was the only one who was interested,” he told the Chicago Sun-Times in 2005.
He continued to look for cases, and by the time he wrote his 1967 paper he had found 50. Once it was published, other doctors in Japan said they had noticed similar cases.
The illness, soon recognized in the United States and elsewhere, had unusual characteristics – appearing in clusters but with no obvious connection among the children, and striking boys disproportionately. About 80 per cent of the patients are 5 or younger, the Kawasaki Foundation says, and the disease can result in heart damage and sometimes death.
In the 2012 interview, Dr. Kawasaki speculated on why distinct cases of the new disease began to emerge in the 1960s. “Probably the use of measles vaccine made it easier to recognize cases of this new entity,” he said, “because measles cases became less common in the population.”
The first cluster in the United States was identified in Hawaii in the 1970s, and there have been a number of outbreaks since then. Researchers now and then come up with a possible cause. A bacterium in dust mites was once posited. Another study suggested that cases turned up in households where the carpets had recently been shampooed. None of those theories have panned out.
Dr. Kawasaki remained a leader in the field, speaking frequently at conferences on the disease and leading the Kawasaki Disease Research Center in Tokyo.
Information on his survivors was not immediately available.
In 2002, in the Pediatric Infectious Disease Journal, Dr. Jane Burns, an American expert in disease, wrote an appreciation of Dr. Kawasaki’s 1967 study, calling it “a masterpiece of descriptive clinical writing.”
“In his exhaustive detailing of every conceivable aspect of the disease,” she wrote, “Kawasaki was part Sherlock Holmes and part Charles Dickens with his sense of mystery and his vivid descriptions.”