What is Rheumatic Fever?
Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated
Group A Streptococcal Infection (GAS), such as strep throat or scarlet fever. It primarily affects children between the ages of 5 and 15 but can also occur in adults.
Etiology
The condition is caused by an autoimmune response to the
Streptococcus pyogenes bacteria. When the body’s immune system responds to the bacteria, it can mistakenly attack its own tissues, particularly the heart, joints, skin, and central nervous system.
Epidemiology
Rheumatic fever is more common in developing countries and areas with limited access to healthcare. Improved living conditions and the widespread use of antibiotics have significantly reduced its incidence in developed nations. However, it remains a major concern in low-resource settings.Transmission
The primary mode of transmission is through respiratory droplets from an infected person. Poor hygiene, overcrowding, and delayed treatment of the initial streptococcal infection enhance the risk of
transmission.
Risk Factors
Several risk factors increase the likelihood of developing rheumatic fever, including: Age: Most commonly affects children between 5 to 15 years.
Genetic predisposition: Family history of rheumatic fever increases susceptibility.
Environmental factors: Overcrowded living conditions and poor healthcare access.
History of previous streptococcal infections.
Clinical Manifestations
Symptoms of rheumatic fever can vary but commonly include fever, joint pain, and swelling (often migrating from one joint to another), skin rashes, and heart inflammation. If left untreated, it can lead to severe complications such as
rheumatic heart disease.
Diagnosis
Diagnosis is typically based on clinical criteria such as the
Jones Criteria, which include major and minor clinical findings along with evidence of a preceding streptococcal infection. Laboratory tests such as throat cultures, rapid antigen detection tests, and anti-streptolysin O (ASO) titers are also utilized.
Prevention
Prevention strategies focus on the timely and effective treatment of streptococcal infections with antibiotics to prevent the initial occurrence of rheumatic fever. Secondary prevention includes long-term antibiotic prophylaxis to prevent recurrence in individuals with a history of the disease.Treatment
Treatment involves eradicating the streptococcal bacteria with antibiotics, managing inflammation with anti-inflammatory medications such as aspirin or corticosteroids, and addressing any cardiac complications. Long-term follow-up is often necessary to monitor and manage potential heart damage.Public Health Implications
Rheumatic fever has significant public health implications, particularly in developing countries. Efforts to reduce its incidence include improving access to healthcare, enhancing diagnostic and treatment capabilities, and implementing public health initiatives focused on hygiene, education, and vaccination.Conclusion
Rheumatic fever remains a challenge in global health, particularly in resource-limited settings. Comprehensive strategies involving early diagnosis, effective treatment, and preventive measures are essential to control and ultimately eradicate this disease.
