Dr Tomisaku Kawasaki
Paediatrician who in 1961 identified a rare inflammatory syndrome latterly linked with Covid-19
DR TOMISAKU KAWASAKI, who has died aged 95, was a Japanese physician who gave his name to a rare inflammatory disorder that tends to occur in young people – and that has symptoms strikingly similar to those observed in some children who test positive for Covid-19.
Kawasaki seldom sought the limelight, and never intended the illness that he identified in 1961 to bear his name. When he first published his observations in 1967, he used the phrase “acute febrile mucocutaneous lymph node syndrome” – but the term “Kawasaki disease” (KD) stuck, and by the 1990s it had become recognised internationally.
Outward symptoms include a prolonged high fever, a patchy all-over rash, bloodshot eyes and a strawberry-red tongue. These occur predominantly in children under the age of five, and tend to resolve themselves within a few weeks. However, subsequent research has suggested that correct diagnosis and early treatment are crucial in order to reduce the risk of more serious complications, including potentially fatal heart damage.
The initial, localised reception of Kawasaki’s 1967 paper was muted. Other Japanese doctors suggested that he was misidentifying an already documented condition. It was thanks in large part to the persistence of Kawasaki and a small pool of fellow researchers that this theory was debunked.
The treatment protocol for KD, which cured most patients and reduced the risk of long-term cardiac problems from 20 per cent to two per cent, was devised amid an international response to an Englishlanguage version of Kawasaki’s findings published in 1974.
Cases were soon found outside Japan, prompting a slew of theories as to the syndrome’s underlying cause. At one time a type of carpet shampoo was – wrongly – held responsible; at another, the cause was thought to be viral or bacterial. What was not in dispute was the importance of that original paper. Grateful parents whose children had been successfully treated for KD would besiege Kawasaki at medical conferences, asking him for autographs.
Kawasaki went on to found a disease research centre in Tokyo, serving first as its chairman and then honorary chairman. Now called the Japan Kawasaki Disease Research Centre, along with its founder it has received renewed attention in light of the coronavirus pandemic.
Tentative findings published in the last few months suggest that children who test positive for Covid-19 may develop a disorder – “multi-system inflammatory syndrome of children”, or MIS-C – affecting their blood vessels. The symptoms closely mirror Kawasaki disease, though as with KD there is as yet no specific diagnostic test for MIS-C.
The youngest of seven children, Tomisaku Kawasaki was born into an impoverished family in Tokyo on February 7 1925. As a child his chief interest was in plants and fruit, but he turned to medicine at his mother’s suggestion, graduating from the institution now known as Chiba University. In 1950 he began work at Tokyo’s Japan Red Cross Medical Centre.
Reflecting on his achievements as a clinician in later life, Kawasaki would stress the importance of careful and steady labour. Though he treated his first patient showing symptoms of KD in 1961, it took years – during which time he documented 50 similar cases – before he had a medical article that would hold up to public scrutiny.
“I wonder if doctors aren’t neglecting the basics of clinical medicine, which is to observe patients thoroughly and analyse what they find,” he told a Japanese newspaper in 2017.
Tomisaku Kawasaki’s wife died in 2019.
Tomisaku Kawasaki, born February 7 1925, died June 5 2020