Heart Health

Updated 17 August 2017

Prevent fatal rheumatic fever

Mozart died of rheumatic fever. So did the poet Robert Burns. So do almost half a million other people worldwide, every year.


Scarily, South Africa has the 4th highest rate of deaths worldwide caused by rheumatic heart disease.

The main reasons for the high death rate are the lack of efficient medical care and living facilities for the poorest in our nation. Rheumatic fever claims about 1 650 lives in South Africa each year, although many cases may not be diagnosed or reported.

Who gets this disease?
Rheumatic fever affects children from as young as five years old and develops after the child has had repeated throat infections known as “strep throat”. This is caused by a bacterium called streptococcus A that has been left untreated.

Repeated bouts of rheumatic fever can lead to the development of rheumatic heart disease. This is a result of the body’s immune system becoming overactive in defence to the streptococcus, thereby leading to tissue damage in the body, including the heart valves.

People with rheumatic fever may develop heart inflammation, which reoccurs when they repeatedly get it. This leads to scarring and damaging of the heart valves.

Symptoms of rheumatic fever include pain and swelling of joints, skin rashes, chest, muscle and abdominal pain, small lumps under the skin, vomiting, shaking and speech difficulties. Children who suffer from a sore throat, but do not have a cough, runny nose or other cold and flu symptoms should immediately be checked by a doctor as they could have strep throat.

If the symptoms are not detected and treated, it could lead to rheumatic heart disease, which is the main cause of heart failure among children.

Any form of heart surgery is expensive, and in the case of rheumatic disease, surgery involves replacement of heart valves, which is very costly. Hospital waiting lists for heart-valve replacement surgeries are long, thus many children die from the disease while awaiting surgery.

Rheumatic heart disease is often the result of effective medicines not being available to people in predominantly rural settings. Inefficient medical care for poorer people also plays a big role. In the United Kingdom, the number of cases dissipated tremendously with the introduction of effective antibiotics and medical treatments, and better housing developments during the 1950s and 1960s.

How to prevent this
Although there is no vaccine for “strep throat”, rheumatic fever can easily be prevented in children. If detected in its early stages, it can be treated by giving the child a penicillin injection. Early detection and treatment can thus spare costly medical bills and much anxiety and despair for parents.

Rheumatic fever is easily treatable in children when caught in its early stages. It can be treated by giving the child a penicillin injection. This can prevent rheumatic heart disease from developing.

- (The Heart and Stroke Foundation SA/Health24, updated May 2010)


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