It was the association of this illness with exposure to honey and the finding of botulinum spores in the honey that led to discovery of its etiology. Rug shampooing, proximity to water, and flooding are clues given to us by the epidemiologists for Kawasaki disease. All suggest an association with dampness. The proper interpretation of this data remains unclear. Perhaps because we do not know the proper questions to ask.
Potential hints are available from the animal data.
Cell wall materials from Lactobacillus casei, L. acidophillus, L. sake, and Streptococcus pyogenes have all been demonstrated to cause coronary arteritis in mice. Although mice are generally susceptible, genetic control of susceptibility to bacterial cell wall-induced diseases is clearly evident in inbred rats. Each of the above bacteria will induce polyarthritis in rats. Not all inbred rat strains are susceptible, but the pattern of strain susceptibility is the same for all of the bacteria. The development of arthritis in the rats and coronary arteritis in mice are not unique manifestations of a single infectious agent, instead they are manifestations of a genetically determined pathologic 'final common pathway' occurring in response to several different agents.