Rheumatic Fever by Dr Robyn Parker

Sore Throats Matter’ and ‘Sore Throats Hurt Hearts’

Rheumatic fever is when the body’s organs react to a bacteria called Group A streptococcus, also known as Group A Strep. This is called an autoimmune reaction. Group A Strep is usually found in the throat and tonsils which your Doctor or Nurse calls Strep Throat or Tonsillitis causing you to have a sore throat. The result of Group A Strep causing this reaction is inflammation or damage to the heart, joints, nervous system and skin. The most common symptom in a person with Rheumatic Fever is a swollen joint, but the major concern is the damage to the heart, in particular the heart valves. Over 60% of people with Rheumatic Fever will have long-term heart damage.

Rheumatic Fever occurs mostly in children aged 5 to 14 years and peaks at about 8 years of age. It is rare in children under 3 years of age and adults over 35 years. Maori and Pacific Island peoples have much higher rates of Rheumatic Fever than New Zealand Europeans.

Most sore throats are caused by viruses, in particular sore throats associated with cough and cold symptoms. But 15-30% of sore throats in children are caused by Group A Strep. Group A Strep is spread by droplets and if you are living in the same household with someone who has Group A Strep your chance of developing it is 20-50%.

Very importantly, Rheumatic Fever can be prevented if antibiotics are taken for your Strep Throat tonsillitis as soon as possible in your sore throat illness and up to 9 days after the start of your sore throat.

The best way to confirm you have Group A Strep throat infection is to see your Nurse or Doctor or School Nurse Clinic and have a throat swab done. This does make you feel like you want to gag but it is a very quick swab that runs over your tonsils and back of the throat. Your Doctor on Nurse may give you antibiotics straight away if they feel from looking at your throat you have Strep Throat and/or if you are a high-risk person to have Strep Throat.

Throat swab results are generally reported within 24 hours of the swab arriving at the laboratory. If your throat swab is positive for Group A Strep then you must complete the full course of antibiotics which is 10 days, this is despite often feeling a lot better within a few days. Make sure you know your throat swab results so you know whether antibiotics are required or not. If you have a positive throat swab for Strep Throat and haven’t been given antibiotics at the time of being seen by your Doctor or Nurse they will need to arrange a prescription for you.

Furthermore if you have more than 3 cases of Group A Strep tonsillitis in your house in in 3 month period your whole family should see your Nurse or Doctor for throat swabs.