#RheumaticFeverWeek: Why sore throats are important

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The Heart and Stroke Foundation of SA said this week that Rheumatic Heart Disease (RHD) is the most common type of acquired heart disease in children and young people below the age of 25 years. The disease results from an illness called Acute Rheumatic Fever (ARF).

In the early 1900s, rheumatic fever was one of the most common causes of death, globally, amongst children and young adults. With improved living conditions and the discovery of antibiotics, it has all but disappeared in high-income countries.

In a statement, the Foundation said Rheumatic Fever itself is an abnormal immune reaction against a common bacterium called Group A Streptococcus. Patients typically experience a range of symptoms that can include joint pain, fever above 38°C, feeling generally unwell and tired with shortness of breath, sometimes a skin rash, and uncontrolled body movements. Rheumatic Fever (RF) is preceded two or three weeks earlier by a bacterial throat infection, commonly called strep throat.

A single episode or repeated episodes of rheumatic fever can cause damage to heart valves. Left untreated, RHD snowballs to further heart valve damage, stroke, heart failure, and death. The disease requires lifelong medication, medical surveillance and often heart valve replacement surgery. Once someone has contracted RF or RHD, it dramatically increases the chance of recurrence.

 Rheumatic fever can be completely prevented by the oldest antibiotic available – penicillin, said Professor Liesl Zühlke, a Paediatric Cardiologist and President of the South African Heart Association: “Effective preventive treatment is both available and cost-effective. It requires that a child with a suspected throat infection is taken to a doctor or clinic, and for a nurse or doctor to correctly diagnose and treat a streptococcal infection”.

Sore throats matter!

  • Strep throat usually presents with throat pain or pain on swallowing, fever higher than 38°C and feeling unwell with a headache, nausea, vomiting or weakness. Inside the throat, the tonsils may be red, swollen or have white pus on them. With the following three actions, everyone can help to reduce strep throat infections:
  • Seek medical advice for a sore throat
  • A child with strep throat should stay away from school to avoid spreading the infection to other children.
  • Teach children good hygiene to prevent the spread of germs

What can communities do? 

On the local level, school teachers and other caregivers can make a difference by simply looking out for a sore throat and by educating parents and children about the ill-effects of a sore throat if left untreated. A sore throat in the absence of a cold or flu could possibly be a strep throat, which can cause rheumatic fever. A child should be taken to the doctor or clinic if a strep throat is suspected.

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