Introduction

Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. It is also known as acute rheumatic polyarthritis or acute articular rheumatism.

Rheumatic fever is a serious complication. It can develop following an untreated throat infection (by a type of bacteria called group A streptococcus).

The symptoms of rheumatic fever include joint pain and swelling (Arthritis) and inflammation of the heart, which can cause shortness of breath and chest pain.

Symptoms usually last around four weeks, but can sometimes persist for several months.

What is acute rheumatic polyarthritis or acute articular rheumatism?*

Acute articular rheumatism is a condition which affects the joints, and most of all, the heart. This is a recidive infectious allergic disease, which is characterized by a proliferative and exudative inflammation, which primarily affects collagenous tissue and its basic component.

In addition to the joints, rheumatism also affects other organs and systems, primarily, the heart. The joints are usually affected only in 50% of other cardiac forms.

What causes rheumatic fever?

The symptoms of rheumatic fever aren't caused by the bacteria itself, but the immune system's response to it.

When your body senses the streptococcal infection, it sends antibodies (infection-fighting molecules)to fight it. However, the antibodies sometimes attack the tissues of parts of the body, such as the joints or heart instead. If the antibodies attack your heart, they can cause your heart valves to swell, which can lead to scarring of the valve "doors" (called leaflets or cusps).

Who is most commonly affected by rheumatic fever?

It has been noted that this disease is most commonly contracted in regions with cold climate and high humidity. This disease occurs most often in winter and fall.

The disease is most common in areas of poverty where the levels of hygiene are low and malnutrition is high, both conditions which hinder the immune capacity of the body. Both genders are equally affected. This disease is especially common for children and young adults up until the age of 25.

Treating rheumatic fever

There's currently no cure for rheumatic fever. Treatment involves relieving the symptoms with medication and trying to prevent permanent damage to the body, particularly the heart.

Once a person has had an attack of rheumatic fever, it's very common for them to have future attacks. This can be prevented by taking a long-term course of antibiotics .

Rheumatic heart disease can lead to serious complications, including heart failure and stroke .

It's estimated that just under half a million new cases of rheumatic fever occur worldwide each year.

The condition is now very rare in the UK as a result of higher standards of living and medical care. It's estimated that less than 1 in 100,000 people in the UK develop rheumatic fever.

Most cases of rheumatic fever first develop in children between the ages of five and 15. It's less likely to affect younger adults, and it's very rare for it to develop in adults who are 35 years of age or over. Both sexes are equally affected.

Outlook

The outlook for people with rheumatic fever depends on whether they've sustained significant heart damage.

If the heart is damaged, it's unlikely to fully recover. In such cases,the symptoms of rheumatic heart disease, such as shortness of breath and constant tiredness, will continue.

If the heart is undamaged, long-term use of antibiotics should prevent rheumatic fever occurring again, which shouldhopefully prevent the heart becoming damaged.

Deaths associated with rheumatic heart disease are very rare in the UK and the rest of the developed world.

Antibiotics
Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. Examples of antibiotics include amoxicillin, streptomycin and erythromycin.

Bacteria
Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and others are good for you.

Disease
A disease is an illness or condition that interferes with normal body functions.

Fever
A fever is when you have a high body temperature (over 38C or 100.4F).

*Section provided by medical author Diana Hysi, MD.