Rheumatic fever

Rheumatic fever is a serious complication that can develop following an untreated throat infection (by a type of bacteria called group A streptococcus).

Rheumatic fever is uncommon in the UK.

Symptoms include:

joint pain and swelling (arthritis)
inflammation of the heart, which can cause shortness of breath and chest pain

Symptoms usually last around four weeks, but can sometimes persist for several months.

Read more about the symptoms of rheumatic fever .

What causes rheumatic fever?

The symptoms of rheumatic fever are not caused by the bacteria itself, but the immune system’s response to the bacteria.

The immune system, which is the body’s defence against infection, mistakes healthy tissue for the streptococcus bacteria and causes parts of the body to become inflamed (swollen and filled with fluid). This triggers the symptoms of rheumatic fever.

Read more about the causes of rheumatic fever.

Treatment

There is currently no cure for rheumatic fever. Treatment involves relieving symptoms with medication and trying to prevent permanent damage to the body, especially the heart.

Once a person has had an attack of rheumatic fever, it is very common for them to have future attacks. This can be prevented by taking a long-term course of antibiotics.

Read more about treating rheumatic fever.

Complications

Rheumatic fever can cause permanent damage to the valves of the heart; this is known as rheumatic heart disease.

Rheumatic heart disease can lead to serious complications, including heart failure and stroke.

Read more about the complications of rheumatic fever.

Who is affected

Rheumatic fever is very common in poorer parts of the world, such as Africa, the Middle East and South America, where there is over-crowding, poor sanitation and limited access to medical treatment. It is estimated that just under half a million new cases of rheumatic fever occur worldwide each year.

The condition is now extremely rare in the UK, due to higher standards of living and medical care. It is estimated that less than 1 in 100,000 people in the UK develop rheumatic fever.

Most cases of rheumatic fever first develop in children between the ages of 5 and 15. It becomes less widespread in younger adults, and it is very rare for it to develop in adults aged 35 or over. Both sexes are equally affected.

Outlook

The outlook for people with rheumatic fever depends on whether they have sustained significant damage to the heart.

If the heart is damaged, it is unlikely to fully recover. Should this happen, the symptoms of rheumatic heart disease, such as shortness of breath and constant tiredness, will continue.

If the heart is undamaged, long-term use of antibiotics should prevent rheumatic fever from occurring again, hopefully preventing further damage to the heart.

Deaths associated with rheumatic heart disease are very rare in the UK and the rest of the developed world.

Antibiotics: Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. Examples of antibiotics include amoxicillin, streptomycin and erythromycin.
Bacteria: Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and others are good for you.
Disease: A disease is an illness or condition that interferes with normal body functions.
Fever: A fever is when you have a high body temperature (over 38°C or 100.4°F).