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It has been found that Kawasaki disease (KD) cases diagnosed in Japan, Hawaii and San Diego, USA increase when tropospheric wind patterns arrive from central Asia, suggesting a common, wind-borne causal agent. We analyzed MD cases hospitalized in Santiago, Chile to look for associations with local, regional and large scale meteorological variables. We compiled monthly data of MD incidence rates, local meteorological variables, large scale wind patterns and several El Nino Southern Oscillation (ENSO) indices for 2001-2010; we considered standardized anomalies in all analyses and used linear time series models to account for data autocorrelation. We found that meteorological variables explain 38% of variance in MD rates. A unit increase in northerly wind at 3 lagged months, temperature at 1 and 3 lagged months and monthly change of ENSO 4 index are associated with changes in MD rates of 0.203 (95% CI 0.049-0358), 0.181 (95% CI 0.014-0347), 0.192 (95% CI 0.030-0353) and 0307 (95% CI - 0.458-0.156), respectively. These results are robust when northerly wind level is changed or when a shorter period (2005-2010) is used to estimate model parameters. We found a statistical association of MD at Santiago, Chile with tropospheric, northerly wind patterns suggesting that dust transported from the Atacama Desert could include a causative agent. A novel result is that ENSO dynamics also explain part of MD variability with a decrease in MD when La Nina is dissipating or El Nino is on the rise; hence climate scale dynamics might be taken into account in future studies worldwide at least as a potential explanatory variable that may confound MD seasonality on a global scale. (C) 2015 Elsevier Ltd. All rights reserved.