When teacher Joseph Mpungwe, who is a member of the Government Employees Medical Scheme (GEMS), took his five-year-old boy to the doctor with a sore throat, his medical practitioner said that he had done the right thing because, while many parents are not aware of it, sore throats can sometimes have dangerous consequences for the health of children and should be treated.
The doctor explained that Joseph's son had what is commonly known as a ‘strep throat', a throat infection caused by the streptococcus bacterium, which, if left untreated, can sometimes lead to the development of rheumatic fever and eventually rheumatic heart disease (RHD), which can cause damage to the heart.
Every year large numbers of South African children and young adults are crippled or die as a result of RHD, an uncommon but serious medical condition caused by rheumatic fever. RHD, which mostly affects children between the age of five and 15 years, results in the deaths of approximately 1 600 people in South Africa every year. Sadly many of these cases can be avoided if strep throat infection is treated.
At the Government Employees Medical Scheme (GEMS) we encourage our members to take control of their family's health and deal with any potential health problems such as strep throat and rheumatic fever so that these can be effectively treated. This article looks at the subject of rheumatic fever and RHD this Rheumatic Fever Week, 5 - 9 August 2013.
South Africa has the fourth highest rate of deaths caused by rheumatic heart disease in the world. RHD is also the most common cause of heart failure in South Africans under 30 years of age. Rheumatic Fever Week aims to inform parents and caregivers about this disease and help to prevent it.
Rheumatic fever is caused by strep throat infection, which causes the production of antibodies to fight off the infection. In some children these antibodies become over-active attacking several parts of the body such as the joints, central nervous system, and the lining and muscle of the heart.
This condition is called rheumatic fever and over time it can cause damage to the heart and particularly the valves of the heart. When rheumatic fever damages the heart in this way we say that the rheumatic fever has caused RHD, a very dangerous medical condition. If damaged heart valves are not treated they deteriorate and eventually cause the heart to fail.
Strep throat is highly infectious and is passed on via sneezing or from hand to hand. Washing your hands regularly and making sure you sneeze away from others can therefore help to prevent the spread of this condition.
RHD tends to be most common among the world's poor communities. Part of the reason for this is that many poor people, especially those living in rural areas, do not have doctors and hospitals close by. They therefore tend to ignore medical conditions such as sore throats, which do not seem to be very serious. The problem is that if rheumatic fever is not treated it causes an increasing amount of damage to organs such as the heart.
It should be kept in mind that if strep throat is treated early with antibiotics, rheumatic fever can be prevented. Children who have a sore throat, should therefore be taken to the doctor/clinic as they could have a strep throat infection that could be causing rheumatic fever. A strep throat is a sore throat without a cough, sometimes with runny nose or other cold or flu-like symptoms.
Rheumatic fever symptoms may come to the fore anywhere between one to five weeks after a child has been infected with the strep throat bacteria. It can have a number of different symptoms, which may vary in different individuals. However, the following are commonly experienced:
Rheumatic fever is more difficult to treat than strep throat. Nevertheless, it is important that it is treated as soon as possible because early treatment of rheumatic fever can help prevent it from developing into RHD, which is a serious and potentially fatal complication.
Treatment of rheumatic fever varies and depends on how far the illness has progressed and on how healthy the patient is. It may involve the patient having to take antibiotics daily or monthly until they are 21 years of age or even for the rest of their lives.
Patients with advanced RHD will need to have their heart valves surgically repaired or replaced with artificial valves. It should be noted, however, that heart repair and replacement procedures are very costly and not everyone is able to easily access the medical expertise necessary to have them done. It is critical therefore that the medical condition is treated as early as possible.
It is important that parents, healthcare workers and teachers are educated and informed about rheumatic fever and the importance of the early treatment. The aggressive treatment of strep throat and rheumatic fever can reduce infection rates and even save lives.
For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.
References:
1. Better Health Channel: www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/rheumatic_heart_disease
2. Nursing and Medicine: www.nurse-ocha.com/2008/08/rheumatic-heart-disease.html
3. Health24: www.health24.com/child/child_health/833-847,28882.asp
4. Heart and Stroke Foundation of South Africa: http://www.heartfoundation.co.za/hearteducation
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