Abstract 13: Elevated Atmospheric Levels of Environmental Allergens Might be Associated with Decreased Risk of an Immunologic Reaction to an Etiologic Trigger in Kawasaki Disease

Introduction: There is considerable interest in identifying potential etiologic and/or triggering agents for the severe immune response associated with Kawasaki disease (KD). The presence of environmental allergens might modulate the odds of triggering such a response despite those allergens not being direct etiologic agents. Methods: We queried the Canadian hospital discharge database (Canadian Institute for Health Information) for hospital admissions associated with a discharge diagnosis of KD in 2011 in the Greater Toronto Area. Atmospheric levels of pollens (35 species), spores (24 species) and fungi (27 species) were measured by Aerobiology Research Laboratories (Nepean, Ontario). A number of separate models were tested using theoretical incubation periods of 0, 7, 14 or 21 days. Correlation between KD cases and atmospheric levels of environmental allergens were assessed in linear regression models. Results: n=145 patients with KD were included. The highest levels of environmental allergens were in summer months. Overall atmospheric pollens levels were not associated with the KD cases (total pollen count r=0.04, p=0.54); there was no consistent pattern of association with specific pollens. . However, higher levels of spores were associated with a decreased prevalence of KD for all spore species (r=-0.23, p<0.001). Associations were observed for 6 of 19 specific species detected (p<0.001), including leptosphaeria, ascospores, oospore, coprinus/coprinellus, basidiospores, and uredinales . The same pattern was observed for all fungi species (r=-0.17, p=0.009). Associations were observed for 5 of 26 specific fungal species (p=0.002), including alternaria, cladosporium, epicoccum, fusarium, and fungi imperfecti . There were no discernable patterns regarding a potential incubation period. Conclusions: High levels of environmental allergens, particularly fungus and spores, were associated with lower incidence of KD. These results suggest that environmental allergens, even if they are not etiologic agents for KD, might modulate the threshold necessary for the actual etiologic/triggering agent. Atmospheric levels of environmental allergens might be partly responsible for the KD seasonality patterns observed in Canada.

Monitoring of fungal spores in the indoor air of preschool institution facilities in Novi Sad

Fungal spores can cause a range of health problems in humans such as respiratory diseases and mycotoxicoses. Since children are the most vulnerable, the presence of fungal spores in the facilities of preschool and school institutions should be investigated readily. In order to estimate air contamination by fungal spores, air sampling was conducted in eight facilities of the preschool institution in Novi Sad during February and March, 2007. Sedimentation plate method was used for the detection of viable fungal spores, mostly being members of subdv. Deuteromycota (Fungi imperfecti). In 32 samples a total of 148 colonies were developed, among which five genera were identified: Penicillium, Cladosporium, Aspergillus, Alternaria and Acremonium while non-sporulating fungal colonies were labeled as sterile mycelia. Most frequently recorded genera were Penicillium with 46 colonies and Cladosporium with 44 colonies. The genera Aspergillus and Alternaria were represented with 3 colonies each and Acremonium with only 1 colony. The greatest number of colonies emerged in the samples from the day care facilities ?Vendi? (58 colonies) and ?Panda? (49 colonies). Most diverse samples were obtained from the day care center ?Zvoncica?, with presence of all identified genera. These results showed notable presence of fungal spores in the indoor air of Preschool institution facilities and indicated the need for further, more complete seasonal research. Obtained information is considered useful for the evaluation of potential mycofactors that endanger health of children.