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IV.D.3 - Keshan Disease

from IV.D - Deficiency Diseases

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Discovery and Characteristics of the Disease

Keshan disease (KD) is a unique endemic cardiomyopathy in China with high incidence and mortality. Its etiology and pathogenesis are not as yet completely clear.

In the winter of 1935, an outbreak of an unknown disease with sudden onset of precardial oppression, pain, nausea, vomiting (yellowish fluid), and fatal termination in severe cases occurred in Keshan County, in Heilongjiang Province of northern China. Because its cause was not known, it was named after the place of outbreak by a Japanese military surgeon (Apei 1937).

Later, Keshan disease was also reported from other parts of China and, in fact, research now indicates that the condition has been prevalent in that country for close to 200 years. The earliest-known account of the disease was found in an inscription on a stone pillar at Jinling Temple, Xiaosi village, Huanglong County, Shaanxi Province, in 1812 (Shan and Xue 1987).

Epidemiological Characteristics

There are three major epidemiological characteristics of Keshan disease. The first is its regional distribution. Keshan disease areas are focally distributed in a belt extending from northeast to southwest China and usually located in hilly land. There are isolated spots known as “safety islands” surrounded by affected areas. The second is population susceptibility. Children below 15 years of age and women of childbearing age in northern China, and children below 10 years of age in southern China, constitute the most susceptible populations. They all live in rural areas and in farm families. The third characteristic is seasonal prevalence. The peak season of Keshan disease in northern China is in winter, but in the south it is in summer. There is also a natural fluctuation of prevalence from year to year.

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Publisher: Cambridge University Press
Print publication year: 2000

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