Beware - Rheumatic fever can damage the heart
Take care if your children develop a sore throat - it may not be as harmless as you think.
A sore throat or streptococcal infection can, in some individuals, cause rheumatic fever, which may damage the heart. Rheumatic fever usually occurs in children and is the most common cause of heart failure in South Africans under 30 years of age.
As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate our members - and future members - on a range of topics, we would like - as part of Rheumatic Fever Week, which is being held between 2 August to 6 August 2010 - to provide you with some information on rheumatic fever, a fairly common and potentially very serious disease.
Rheumatic fever is an inflammatory disease that may develop after an untreated sore throat or streptococcus infection. It has been estimated to occur in around 3% of people with an untreated streptococcus infection. It is common around the world, but is particularly prevalent in developing countries such as South Africa. It mainly affects children aged between three and 15 years. Only 20% of first time attacks occur in adults. Rheumatic fever affects especially the skin, nervous system, joints and the heart. Repeated infections can cause damage to the heart valves and finally lead to heart failure.
Streptococcus infection or "strep throat", as it is widely known, is easily passed on in more crowded conditions and is therefore more readily passed on among the people of poorer communities. Rheumatic fever is more commonly found in poorer children although it is not confined to them and anyone could potentially become a victim of the disease.
According to the Heart and Stroke Foundation of South Africa: "Repeated [streptococcus] infections can cause damage to the heart and by their late teens or early 20s the victims may be in need of heart valve replacement surgery, and this in the prime of their lives. Complications such as leaking heart valves may result in heart failure or even shortness of breath, body swelling and an inability to sleep at night. The end result of all of this could be general incapacity and a need to be cared for."
As the Foundation points out, this is a tragic situation because rheumatic fever that is caught before it has had a chance to damage the heart valves can be relatively easily treated with antibiotics such as penicillin.
In some cases where there is a high risk of streptococcus infection reoccurring and causing damage to the heart once more, long-term treatment with penicillin may be recommended. About half of children who have had rheumatic fever will develop it again if they get another case of strep throat and it is left untreated. Anti-inflammatory medications such as aspirin or corticosteroids are often used to reduce inflammation and help manage the rheumatic fever. High doses of aspirin are most commonly used, but remember that aspirin should not be used in children as they are at risk of developing an illness called Reye's syndrome from it.
One of the problems with rheumatic fever is that it is not so easily diagnosed. Symptoms can vary a great deal and depend upon which parts of the body become inflamed. The actual illness may commence a few weeks after the sore throat and it may present in the following ways:
It should be kept in mind that individuals may present with only one or several symptoms at the same time. Some people may not have any symptoms at all and might not even be aware that they have an illness. Others may go on to develop a shortness of breath, feel tired all the time, start vomiting and even suffer heart failure. The above symptoms could also be linked to conditions other than rheumatic fever so one should never assume you or your children have the disease until it can be positively confirmed.
Rheumatic fever can be an extremely serious condition if it is not treated in time, so don't hesitate to get a healthcare professional's opinion or advice should your child develop a persistent sore throat. Your vigilance could just save his or her life.
If you have any more questions regarding rheumatic fever you can phone the GEMS call centre on 0860 00 4367 or send a SMS to 083 450 4367. GEMS will assist you in every way possible to ensure your family's health and well-being.
Sources
‘Rheumatic Fever', The Heart Foundation of South Africa, www.heartfoundation.co.za/heartcondition/heartcondition_9.htm
‘Rheumatic Fever', MedlinePlus, US National Library of Medicine, www.nlm.nih.gov/medlineplus/ency/article/003940.htm
‘Rheumatic Fever: Bacterial Infections', Merck Manual - Home Edition, www.merck.com/mmhe/sec23/ch272/ch272h.html
‘Rheumatic Fever', eMedicine Emergency Medicine, www.emedicine.medscape.com/article/808945-overview
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