Walsh & Hoyt: Cause

The cause of KD remains unknown. Both infectious and immunologic causes are hypothesized. Features consistent with a childhood infection include the acute onset of the illness, the associated fever, and the aseptic meningitis that occasionally is part of the disease. Seasonal occurrence and the development of community-wide epidemics also suggest an easily transmitted infectious agent of low virulence that is spread by respiratory secretions. The agent presumably infects nearly all young children in a community but causes clinical disease in only a small proportion of them, perhaps those with a genetic predisposition.