How Can You Actually Catch Rheumatic Fever?
The truth is, you can’t directly catch rheumatic fever from someone else. Rheumatic fever is a serious inflammatory condition that develops as a complication of untreated strep throat or scarlet fever caused by group A Streptococcus bacteria.
What is Rheumatic Fever, Really?
Rheumatic fever (RF) isn’t infectious in the traditional sense. It’s not like the common cold or flu, which spread directly from person to person. Instead, RF is an autoimmune reaction. This means the body’s immune system, confused by the similarity between the Streptococcus bacteria and certain tissues in the body, mistakenly attacks those tissues – primarily in the heart, joints, brain, and skin. This immune system misfire is what leads to the symptoms and long-term damage associated with rheumatic fever.
The Chain of Events: Strep Throat to Rheumatic Fever
The development of rheumatic fever follows a clear sequence:
- Strep Throat or Scarlet Fever Infection: A person becomes infected with group A Streptococcus bacteria, leading to strep throat (pharyngitis) or scarlet fever (strep throat with a characteristic rash).
- Untreated or Inadequately Treated Infection: If the Streptococcus infection is not promptly and effectively treated with antibiotics (usually penicillin or amoxicillin), the bacteria can linger in the body.
- Immune System Response: The body’s immune system fights off the bacteria. However, antibodies produced by the immune system can sometimes mistakenly attack the body’s own tissues.
- Rheumatic Fever Development: The autoimmune attack leads to inflammation and damage, resulting in rheumatic fever. This typically occurs 2-4 weeks after the strep infection.
Essentially, how can you catch rheumatic fever? You don’t “catch” it directly; you develop it as a complication of an untreated Streptococcus infection.
Why Doesn’t Everyone with Strep Throat Get Rheumatic Fever?
Not everyone who gets strep throat or scarlet fever will develop rheumatic fever. Several factors influence the likelihood of developing the condition:
- Strain of Streptococcus: Certain strains of group A Streptococcus are more likely to trigger RF than others.
- Genetic Predisposition: There appears to be a genetic component to RF susceptibility. Some individuals are genetically predisposed to developing the autoimmune response.
- Age: Rheumatic fever is most common in children between the ages of 5 and 15, though it can occur in adults.
- Access to Healthcare: Prompt diagnosis and treatment of strep infections significantly reduce the risk of RF. In regions with limited access to healthcare, RF is more prevalent.
Symptoms of Rheumatic Fever
The symptoms of rheumatic fever can vary in severity and may include:
- Fever: Elevated body temperature.
- Joint Pain and Inflammation: Pain, swelling, and tenderness in the joints (polyarthritis), often affecting large joints like the knees, ankles, elbows, and wrists.
- Carditis: Inflammation of the heart, which can lead to permanent heart damage (rheumatic heart disease). Carditis can manifest as shortness of breath, chest pain, or heart murmur.
- Sydenham’s Chorea: Involuntary, jerky movements (chorea), usually affecting the face, arms, and legs.
- Erythema Marginatum: A painless, ring-shaped rash that appears on the trunk and limbs.
- Subcutaneous Nodules: Small, painless bumps under the skin, usually near joints.
Prevention is Key: Treating Strep Throat
The most effective way to prevent rheumatic fever is to promptly and completely treat strep throat and scarlet fever with antibiotics. If your child (or you) experiences symptoms of strep throat (sore throat, pain when swallowing, fever, red and swollen tonsils, sometimes with white patches), it is crucial to see a doctor for diagnosis and treatment. A rapid strep test or throat culture can confirm the diagnosis. Completing the full course of antibiotics is essential to eradicate the Streptococcus bacteria and prevent the development of RF.
Rheumatic Heart Disease: A Serious Complication
Rheumatic heart disease (RHD) is the most serious long-term complication of rheumatic fever. It occurs when the inflammation from RF damages the heart valves, leading to scarring and narrowing (stenosis) or leakage (regurgitation) of the valves. RHD can cause:
- Heart Failure: The heart struggles to pump enough blood to meet the body’s needs.
- Arrhythmias: Irregular heartbeats.
- Stroke: Blood clots can form on damaged heart valves and travel to the brain, causing a stroke.
- Death: Severe RHD can be fatal.
Preventing RF, therefore, is critical to preventing rheumatic heart disease. Secondary prophylaxis (long-term antibiotic treatment) is often recommended for individuals who have already had RF to prevent recurrent strep infections and further heart damage.
How Can You Catch Rheumatic Fever?: FAQs
Is rheumatic fever contagious?
No, rheumatic fever itself is not contagious. It is a complication of an untreated strep throat or scarlet fever infection. The Streptococcus bacteria, which cause strep throat, are contagious and can spread through respiratory droplets from coughing or sneezing.
Can adults get rheumatic fever?
While rheumatic fever is more common in children and adolescents (ages 5-15), adults can get it, although it is less frequent. The underlying cause remains the same: an untreated or inadequately treated strep throat infection.
What are the long-term effects of rheumatic fever?
The most significant long-term effect is rheumatic heart disease (RHD), which can cause permanent damage to the heart valves. RHD can lead to heart failure, arrhythmias, stroke, and even death.
How is rheumatic fever diagnosed?
Diagnosis typically involves a combination of factors, including: a history of strep throat, clinical symptoms (fever, joint pain, carditis, etc.), laboratory tests (including blood tests to detect Streptococcus antibodies and markers of inflammation), and echocardiogram (to assess the heart). The Jones Criteria are often used to aid in the diagnosis.
What is the treatment for rheumatic fever?
Treatment focuses on controlling inflammation, eradicating the Streptococcus bacteria (if still present), and managing symptoms. This usually involves:
- Antibiotics (e.g., penicillin) to eliminate any remaining Streptococcus infection.
- Anti-inflammatory medications (e.g., aspirin, corticosteroids) to reduce inflammation and pain.
- Medications to manage specific symptoms, such as heart failure or chorea.
What is secondary prophylaxis for rheumatic fever?
Secondary prophylaxis involves long-term antibiotic treatment (usually penicillin) to prevent recurrent strep infections and reduce the risk of recurrent rheumatic fever and progressive heart damage. The duration of secondary prophylaxis depends on the severity of the initial rheumatic fever and the presence of rheumatic heart disease.
Can rheumatic heart disease be cured?
Unfortunately, rheumatic heart disease (RHD) is often not curable. The damage to the heart valves is usually permanent. However, the symptoms and complications of RHD can be managed with medications and, in some cases, surgery to repair or replace damaged heart valves.
Is there a vaccine for rheumatic fever?
Currently, there is no vaccine specifically for rheumatic fever. However, research is ongoing to develop a vaccine against Streptococcus bacteria, which could help prevent strep throat and, consequently, rheumatic fever.
Are there any natural remedies for rheumatic fever?
There are no proven natural remedies for rheumatic fever. It’s crucial to seek prompt medical attention and treatment with antibiotics and anti-inflammatory medications as prescribed by a doctor. Attempting to treat rheumatic fever with only natural remedies can be dangerous and lead to serious complications.
What are the Jones Criteria for rheumatic fever?
The Jones Criteria are a set of guidelines used to help diagnose rheumatic fever. They include major and minor criteria:
- Major Criteria: Carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules.
- Minor Criteria: Fever, arthralgia (joint pain), previous rheumatic fever or RHD, elevated ESR or CRP (markers of inflammation), prolonged PR interval on ECG.
A diagnosis of rheumatic fever typically requires evidence of a preceding strep infection (e.g., positive strep test or elevated Streptococcus antibodies) plus either two major criteria or one major criterion and two minor criteria.
Is rheumatic fever common in developed countries?
Rheumatic fever is less common in developed countries due to improved access to healthcare and prompt treatment of strep throat infections. However, it is still a significant public health problem in developing countries and underserved communities.
What should I do if I suspect my child has rheumatic fever?
If you suspect your child has rheumatic fever (especially if they have recently had strep throat), seek immediate medical attention. Early diagnosis and treatment are crucial to prevent long-term complications, particularly rheumatic heart disease.