Rheumatic fever continues to be a major health hazard world over. The disease has been described since the 1500s, but the association between a throat infection and rheumatic fever symptom development was discovered in the 1880s.
Although this burden of a disease has come down in developed countries, it continues to be a prominent cause of morbidity and mortality in the developing countries. It is an autoimmune disease that may develop as a complication of a streptococcus infection, such as strep throat or scarlet fever (caused by Streptococcus pyogenes or group A beta-hemolytic streptococcus). If it does develop, it will usually do so 2 to 3 weeks after the Group A streptococcal infection.
Rheumatic fever mainly affects children aged between 5 and 15 years; however, it can affect adults and younger children. The disease may cause long term effects on the skin, heart, brain and joints. Rheumatic fever may cause permanent damage to the heart valves (rheumatic heart disease). Rheumatic fever has the potential to cause heart failure, stroke and even death.
Signs & Symptoms
Rheumatic fever is a complication of strep throat. If your child has any of the following symptoms, a strep test is needed.
- Sore throat or sore throat with tender and swollen lymph nodes.
- Trouble swallowing.
- Thick, bloody discharge from nose.
A wide variety of symptoms are associated with rheumatic fever. An individual with the illness could experience a few, some, or most of the symptoms below. Symptoms usually appear 2 to 4 weeks after your child has been diagnosed with strep throat. Common symptoms include fever, painful/tender joints in the ankles, knees, elbows, and wrists; pain in one joint that moves to another joint; red, hot, swollen joints; small nodules (bumps) under the skin that don’t hurt; chest pain; rapid fluttering or pounding chest palpitations; fatigue; nosebleeds; stomach pain; shortness of breath; short attention span; sweating; vomiting; flat, slightly raised, ragged rash; jerky uncontrollable hand, feet, face movements; outbursts of crying or inappropriate laughter.
The following situations require that you seek medical advice and or attention:
- Fever that is over 100 °F in newborns to 6-week-old infants.
- Fever that is 102 °F or higher in babies 6 weeks to 2 years old.
- Fever that is 103 °F or higher in children age 2 years or older.
- Fever that lasts more than three days.
Genetics: Some individuals possibly carry genes (or a gene) that make them more susceptible to developing rheumatic fever. A person with a family history of rheumatic fever has a higher risk of developing it himself/herself.
Type of strep bacteria: Some strep bacteria strains are more likely to lead to rheumatic fever than others.
Environment: Such factors are overcrowding, poor sanitation and poor access to healthcare increase the risk of rheumatic fever.
Rheumatic fever may develop as a complication after a throat infection with Streptococcus pyogenes, or group A streptococcus (a bacterium). Strep throat, and less commonly scarlet fever are infections caused by Group A streptococcus infections.
Experts believe that the bacterium upsets the patient’s immune system. Strep bacteria have a protein which is similar to one found in some tissues in our body. Immune system cells that would usually target the bacterium may subsequently start attacking the body’s own tissues as if they were toxins or infectious agents, especially tissues of the heart, joints, CNS (central nervous system) and skin, resulting in inflammation.
How is rheumatic fever diagnosed?
The doctor will first want to get your child’s medical history, including his or her current symptoms. The doctor will also want to know if your child has had a recent bout of strep throat. Next, a physical exam will be given that includes the following.
- Checking joints for inflammation
- Looking for rash or skin nodules (hard bumps beneath the skin)
- Listening to heart to check for abnormalities
- Movement tests to determine nervous system dysfunction
- Blood tests for strep bacteria
- EKG (measures the electric waves of the heart)
- Echocardiography (uses sound waves to produce image of the heart)
How to prevent rheumatic fever?
The best way to prevent rheumatic fever is to fully treat all strep throat and scarlet fever infections. Make sure your child completes all prescribed doses of medication. In addition, schedule a follow-up visit to ensure that your child is free from the strep bacteria antibodies.
Once developed, the symptoms of rheumatic fever can last for months. Rheumatic fever can cause long-term complications in certain situations. One of the most prevalent complications is rheumatic heart disease. Other heart conditions include:
- Valve stenosis—a narrowing of the valve.
- Valve regurgitation—a leak in the valve that causes blood to flow in the wrong direction.
- Heart muscle damage—inflammation can weaken the heart muscle, which can decrease the heart’s ability to pump blood effectively.
- Atrial fibrillation—irregular heart beat (in the upper chambers).
- Heart failure—heart can no longer pump blood to all parts of the body.
Ayurvedic Management of Rheumatic Fever
In Ayurveda, rheumatic fever is called Amavata Jwara. Ayurveda emphasizes that rheumatic fever can be treated by leading a modified lifestyle and consuming proper diet along with some ayurvedic herbal formulations. The following are a few tips that it offers.
- Always try to eat food which are easily digestible. Take food regularly at the stipulated time. Eat between 10 am to 12 am and 5 pm and 7 pm and take very light evening meals.
- Fasting one day per week helps a lot.
- Try to be in warm climate and totally avoid cold environments.
- Keep your bowel movements regular and avoid constipation.
- Maintain your height to weight ratio or body mass index.
- Relaxation techniques are very helpful in managing stress that the patient undergoes as he has to live with this chronic disease.
- Take walks or use a treadmill or stationary bicycle or water aerobic classes.
- Do a regular yogic practice like pawanmuktasana that are meant for treating rheumatic fever.
- Pranayama or breathing technique helps in digestion and also to fight the depression related to rheumatic fever.
- Always have a wholesome diet which is nutritious that includes fresh and green vegetables, fruits.
- Take chapattis, rice, millet, barley etc., but do not include milk and its products more in your diet.
- Take a plenty of boiled vegetables but reduce intake of onions.
- Avoid taking alcohol.
There are some Ayurvedic medicines available but they need to be taken only after consulting an Ayurvedic practitioner.