Rheumatic Fever: Prevention Before Affecting to Your Heart

     ‘Streptococcus’ – A Name Many Have Heard During Outbreaks. Japan serves as a clear example: once infected, each individual’s body may respond to the bacteria in different ways, resulting in a range of diseases. Seeking prompt medical attention is essential and the illness should not be left to progress untreated, as rheumatic fever could develop.

Group A Streptococcus

     Group A Streptococcus is a type of bacteria that causes pharyngitis (sore throat) and is transmissible through inhaling droplets from coughs or sneezes, as well as through direct contact or sharing items with an infected individual. This bacterium can result in a scarlet fever rash or more serious complications, such as rheumatic fever or nephritis.

Generally, Group A Streptococcus causes illness in two major forms:

• Suppurative infections resulting in pus formation
• Illness caused by bacterial toxins or an abnormal immune response to the infection

These symptoms typically subside within a few days. However, in 2–3 weeks after recovery, children may be at risk of developing rheumatic fever.

Rheumatic Fever

     Rheumatic fever is a complication that can arise following a Group A Streptococcus infection, particularly affecting children between the ages of 5 and 15. If the infection occurs in the throat or tonsils, the inflammation can spread to the heart muscle, pericardium, heart valves, and other organs such as the joints, brain, and skin.

Severity Leading to Rheumatic Heart Disease

     Rheumatic fever can affect individuals of all ages, though infection often begins in childhood. Initial inflammation may progress to cause myocarditis (heart inflammation) and potentially lead to leaking heart valves. In chronic cases, this can result in valve stenosis and eventually heart failure. In some cases, the damage is severe enough to cause permanent heart defects, a condition known as rheumatic heart disease.

Risk of Recurrence and the Importance of Ongoing Treatment

     Patients who have had rheumatic fever are at risk of recurrence. Therefore, consistent adherence to prescribed medications—whether oral or injectable—is crucial in reducing the chances of recurrent episodes and potential complications.

Preventing Rheumatic Fever

     Rheumatic fever itself is not contagious, but its cause—Group A Streptococcus—is. Prevention begins with simple hygiene practices such as wearing face masks, washing hands thoroughly with soap, maintaining appropriate social distance, not sharing personal items with infected individuals, and avoiding crowded places when possible.

Preventive Measures Based on Severity of the Condition

Case I

In cases where preventive treatment should not stop before age 21:

• No evidence of heart inflammation
• Mild heart inflammation without residual valve damage

Case II

In cases where preventive treatment should not stop before age 40 or should continue for life:

• Severe heart inflammation
• Persistent valve leakage

If a patient undergoes heart valve surgery due to rheumatic heart disease, lifelong prevention is required.