By Tan Yi Hui

The death of Hollywood star John Travolta's son earlier this month spotlighted a little-known disease.

Sixteen-year-old Jett died on Jan 2, reportedly due to a fall caused by seizures.

He was diagnosed at age two with Kawasaki disease, a condition involving the inflammation of blood vessels. It affects mainly children under the age of five.

Travolta and his wife, actress Kelly Preston, had attributed many of Jett's developmental problems to the illness, according to international media reports.

This has led worldwide news networks such as CNN to speculate whether Kawasaki was the cause of Jett's death, even though official autopsy results have not been made public.

Dr Quek Swee Chye, a cardiologist at the National University Hospital (NUH), says it is unlikely Kawasaki is to blame. 'I don't think so, unless Jett was on blood thinners, such as warfarin for possible complications from Kawasaki disease, and had a fall, which resulted in bleeding in the brain.'

Experts quoted by CNN agree with him that the illness is probably not the cause of Jett's death.

The cause of the disease remains unknown, although it is suspected that an external agent triggers it in genetically pre-disposed children. There are studies that link toxins in carpet-cleaners to the disease - which is what the Travoltas blame it on - but experts say this is not proven.

There is also no conclusive test to diagnose the disease, which is named after Dr Tomisaku Kawasaki, the Japanese paediatrician who first described the illness in 1967.

Symptoms almost always include a prolonged high fever. Other possible signs are a skin rash, red eyes and lips, or swollen hands and feet, where the skin may peel. Patients may also have swollen lymph nodes and develop a 'strawberry tongue' - bright, shiny, red spots on the tongue.

According to doctors, the incidence here of Kawasaki disease among children under five years old may range from 40 to 63 per 100,000 cases.

The disease is also more prevalent in Asian countries. Singapore's rate is more than twice that of the United States, and in Japan, the figure is about 184 cases per 100,000 children under age five.

Its variable symptoms are why the disease is hard to detect. A father, who wants to be known only as Mr John Tan, says his son, now two, contracted the illness when he was seven months old.

'My experience was a nightmare,' says Mr Tan. A paediatrician diagnosed the disease in his son, who was suffering from high fever, and referred the child to the hospital. But the doctors at the hospital administered treatment only after nine days because, according to them, the symptoms were unclear, claims Mr Tan.

Treatment for the disease involves intravenous gammaglobulins or the transfusion of purified and concentrated antibodies from donated blood.

According to Dr Tan Teng Hong, a cardiologist from KK Children's and Women's Hospital (KKH), the success rate for this is usually good - up to 94 per cent. However, patients may have to follow up with regular check-ups and be on life-long medication, depending on the severity of the illness.

As the disease involves the inflammation of blood vessels, the biggest complication is the damage of blood vessels to the heart or coronaries. If untreated, there is a 20 per cent risk of this happening, say experts.

Dr Tan says fatalities from the disease are very rare, though patients may be more prone to heart diseases at a younger age in adulthood.

Mr Tan's son eventually recovered, but not before suffering some damage to his coronaries. For months after the incident, he had to take medication. He is still going for check-ups and heart scans.

Mr Tan says: 'More awareness should be raised by the authorities on this disease. Because it is uncommon, most parents may not have heard of it. But Kawasaki disease is a serious illness and it's not something that should be sneezed at.'

KKH's Dr Tan adds that cases at his hospital have almost doubled over the past decade. He says: 'It's a very important disease although it's not very well known.'

tanyihui@sph.com.sg

This story was first published in thesundaytimes on Jan 11, 2009.