PURPOSE: The etiology of the Kawasaki disease remains unclear, many strong clinical and epidemiologic characteristics suggest an infectious etiology. However, conventional bacterial and viral cultures and extensive serologic studies have not revealed a consistent causative agent. Thus we studied the Epstein Barr virus(EBV), one of the most important pathogens, to access the association between the EBV and Kawasaki disease. METHODS: Seventy-two patients with Kawasaki disease were studied between June 1993 and July 1994 at Ewha Womans University Hospital. The control children were composed of 145 patients who have no evidence of Kawasaki disease or EBV infection. The VCA -IgM and IgG titer were measured in both groups by Enzyme Linked Immunosorbent Assay. RESULTS: 1) The positive rate of VCA-IgG was significantly higher in Kawasaki disease group (75.0%) compared with the control group(59.4%). 2) The positive rate of VCA-IgM, the indicator of acute EBV infection, was significantly higher in Kawasaki disease(13.9%) compared with the control group(2.1%). CONCLUSIONS: The high positive rate of EBV antibody measured in Kawasaki disease patients suggested that EBV might be etiologic pathogen of Kawasaki disease. While the stereotyped nature of Kawasaki disease makes the multiple pathogenesis, more extensive research for identifying the cause of Kawasaki disease will be necessary.