One can only feel sympathy for the Travoltas, who lost their beloved son Jett in a seizure.

They were Scientologists. Was this church related dogma to blame for the child’s failure to use the seizure medicine that could have saved his life?

So when I read that the Travoltas had refused to go along with their son’s obvious symptoms of “autism”, and blamed his seizures on an episode of Kawasaki’s disease caused by using rug cleaners, I wondered if they, like many parents when confronted with a child’s illness whose cause could not be explained by medical science, had gone into the realm of conspiracy theories.

But ironically, the answer is probably no.

Let’s start with Kawasaki syndrome.

I’ve only seen one case of the disease, and the disease was not recognized until 1970.

The cause is unknown: there are questions if it is a virus or if it is a variation of “auto immune” disease, since the swelling of the hands and feet and the dreaded complication, aneurysms of the blood vessels of the heart, resemble a rare disease called polyarteritis nodosum.

Kawasaki’s disease looks like a lot of other childhood diseases.

It is usually in small children, and starts with a fever and lymph nodes in the neck.

Well, that describes half the sick kids in my office.

The kids with Kawasaki’s disease, however, might have a mild “pink eye” or sore tongue. But the disease is only recognized when the fever doesn’t go away with “watchful waiting” or antibiotics, and the “clue” is that the kids get a rash on their hands and feet, which also might swell up (edema).

At this point, usually a pediatrician would be able to diagnose the case (the only case I treated was transferred for “fever of unknown origin” after five days of antibiotic treatment and quickly diagnosed at the referral hospital).

So why wasn’t the disease recognized in the “good old days”?

It may have been missed: In the days before Penicillin, some children died with heart problems after “scarlet fever”, and it was presumed the problem was either toxins from the infection or Rheumatic fever…yet one preserved heart in London from a child who died of “scarlatinal dropsy” was reexamined and found to have signs of Kawasaki type aneurysms of the Coronary Arteries.

But what about cases after we started using antibiotics for streptococcal infections? One reason we might not have seen it is because might be because doctors and parents  in the good old days used Aspirin to treat fevers.

And the treatment for Kawasaki’s disease? Aspirin, and immune globulin.

So what causes Kawasaki’s disease?

It doesn’t seem to be infectious, but there have been “outbreaks” or clusters reported in Japan. So it may be one of those problems where the immune system goes wild after a virus or bacterial infection and attacks the person’s body.

This brings up three questions: what virus causes the immune system to go haywire? Do vaccines cause some children’s immune system to go haywire? And are there other causes, such as chemicals or environmental causes, that do so?

Answer: No body knows.

An interesting observation is that Kawasaki’s disease causes redness and swelling of the BCG vaccine site (BCG induces an immune reaction to lower the incidence of Tuberculosis). But BCG is not used in the US, which nevertheless has cases of Kawasaki disease.

What about Rotavirus vaccine? Again, Rotavirus is common disease that causes a nasty diarrhea in kids, which is  bad enough to kill a lot of  kids in the third world.

The CDC study showed the five cases of Kawasaki disease after being given the vaccine was not significantly higher than the rate of kids who didn’t get the vaccine. (5/36000 vs 1/36000) but warned doctors to keep an eye out for the problem.

But the same article does note this:

  • Kawasaki syndrome has been seen after a variety of infectious or environmental exposures including a prior respiratory illness, exposure to carpet-cleaning chemicals, use of a humidifier, and living near a body of water. There is no firm evidence that Kawasaki syndrome is caused by any of these factors. Kawasaki syndrome has not been linked to vaccinations. (italics mine).

So Kelly Travolta’s theory that her son’s problems were due to carpet cleaning fluid are probably not true, but then again she might be right.

But what about Kawasaki’s disease as the cause of Jett’s “problem” ( some suggest he had a mild case of autism)?

There are reports that one quarter of children with Kawasaki’s disease have aseptic meningitis. And aseptic meningitis can cause subtle or severe brain damage…and children with brain damage often have some of the symptoms listed as “autism”.

Autism is a “syndrome” (a combination of symptoms and physical findings) not a “disease” (which suggests a single cause). Autism can be cause by many things, from “Fragile X syndrome”  to Fetal rubella syndrome, or pther causes of mental retardation (where behavior changes are observed from the time of birth)  but one can also see a type of autism where a child is normal, but then gets a “high fever”, and then starts to deteriorate.

So was Jett’s syndrome cause by aseptic meningitis from Kawasaki’s disease? I have no idea. But again the parent’s supsicions may have some basis in fact.

Finally, there is a very big question about why a child should die of a seizure, when anti seizure medicines can control seizures in most people with epilepsy.

Again, the suspicion is that the child didn’t take seizure medicine because Scientology thinks all mental diseases can be cured by their “treatments”.

Yet the UKTimes reports that Jett had been on the drug Depakote to control seizures for years, but it “lost it’s effectiveness”.

Well, yes, but there are a lot of other medicines out there. But a lot of time, the amount of medicine needed to control seizures can cause sleepiness or other side effects. So one can see if a child has only an occasional seizure which isn’t too severe, parents whose church dislikes medicines that affect the mind might decide that they can live with the seizures.

Seizures are rarely fatal, but in this case, apparently something happened.

The most common cause of death in seizures is “status epilepticus”, where a seizure starts and won’t stop. I’ve seen cases where the seizures go on and off for hours…usually we doctors stop the seizure with medicines, and if there is a problem in breathing, we intubate.  Often the cause of death is usually because the person lacks oxygen, but death is often from other causes, where the lack of oxygen causes a heart attack or aspiration of food.

Yet in this case, the child was found quickly, and he was not having a seizure when CPR was started by his father, making one think that this was sudden death due to cardiac arrhythmia from lack of oxygen from the seizure.

The autopsy claims death was from the seizure, but one will have to await specialized “microscopic” examination to check if the underlying cause might have been subtle cardiac damage from his Kawasaki’s disease.

In summary, our hearts go out to the Travolta’s in this tragedy.

One hopes that one “good” result of this tragedy will not be conspiracy theories, but some solid scientific investigations on the causes of the strange disease first described by Dr. Kawasaki.

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addendum: Like many physicians, I am not fond of the cult of Scientology, whose war against medicines for the mentally ill has the potential to harm many patients suffering from depression, schizophrenia and other biological mental illnesses.

Yes, it is true that many psychotropic medicines are probably over-used for “minor” psychiatric problems,  or for those where non drug treatment would be a better alternative,  but I remind the skeptics

“…O the mind, mind has mountains; cliffs of fall
Frightful, sheer, no-man-fathomed. Hold them cheap
May who ne’er hung there…”

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Nancy Reyes is a retired physician living in the rural Philippines. She writes medical essays at HeyDoc Xanga Blog

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