Conditions caused by rheumatic fever affect and kill millions of children, adolescents and young adults in the world. The ASAP programme is aimed at early detection and prevention of these conditions.

Rheumatic fever is an inflammatory disease that may affect many parts of the body, such as the heart, joints, skin and brain. It may develop after an infection with the streptococcus bacteria, for example strep throat or scarlet fever. Single or repeated occurrences of rheumatic fever can lead to chronic rheumatic heart disease.

Symptoms

Rheumatic fever mainly affects children aged between 6 and 15 years of age and occurs approximately 20 days after the child was diagnosed with strep throat or scarlet fever. Rheumatic fever rarely affects people before the age of 4 or after the age of 40, and it usually occurs in isolated outbreaks.

Heart inflammation affects about half the people affected and can lead to heart failure in some people. It can also damage the heart valves.

Other symptoms may include:

    • Stomach pain
    • Fever
    • Heart problems
    • Joint pain, swelling; redness or warmth
    • Lumps (nodules) under the skin and skin rash
    • Rapid, jerky movements.

Treatment

This disease has different forms and there is not a single test that can firmly diagnose it. Your doctor will examine you and will carefully check your heart sounds, skin and joints.

There is no cure for rheumatic fever once it has developed, but medication can be used to get rid of any remaining streptococcal infection. Treatment consists of antibiotics and you may have to take low doses of antibiotics over the long term to prevent strep throat from returning.

Anti-inflammatory medications such as aspirin may reduce fever and relieve joint pain and swelling.

Outlook

Rheumatic fever is likely to return in people who do not take low-dose antibiotics continually, especially during the first 3 to 5 years after the first episode of the disease. Heart complications may be severe, particularly if the heart valves were affected.

Prevention

The most important and primary way of preventing rheumatic fever is by getting antibiotic treatment for streptococcal infections, such as strep throat and scarlet fever, immediately and effectively. The treatment mentioned above may prevent recurring rheumatic fever.

Rheumatic fever and rheumatic heart disease in South Africa

There is still an unacceptably high percentage of rheumatic fever and rheumatic heart disease in southern Africa, despite readily available and inexpensive preventative measures. However, key players in Africa’s healthcare and political arena developed a treatment programme known as ASAP. The ASAP programme targets efforts to raise Awareness, establish Surveillance systems, Advocate for increased resources for treatment, and promote Prevention strategies in communities.

 

Sources

ASAP Programme. Retrieved from http://www.pascar.org/news/entry/a.s.a.p.-programme1
Rheumatic heart disease and the ASAP programme: fresh insights into an old disease. Retrieved from http://www.cmej.org.za/index.php/cmej/article/view/2281/2050

 

(Revised by M van Deventer)