The rise and fall of acute rheumatic fever and rheumatic heart disease: a mini review

Abstract

IntroductionThe incidences of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), which were leading causes of death in children in the 1920s, have decreased substantially. Considering the recent resurgence of scarlet fever and increased incidence of streptococcal pharyngitis in children, an investigation of the current status of ARF and RHD may be worthwhile.ObjectiveTo summarize the prevalence trends, pathogenic factors, and prevention strategies for ARF and RHD in children.MethodsA selective search of literature published between January 1920 and February 2023 was done in PubMed, using the terms “acute rheumatic fever”, “rheumatic heart disease”, “group A Streptococcus”, “pharyngitis”, “pharyngeal tonsillitis”, “scarlet fever”, “impetigo”, “obstructive sleep apnea syndrome” and “child”.ResultsOvercrowded homes and inadequate sanitation led to recurrent group A streptococcal infection, and the causal relationship between group A streptococcal infection and ARF/RHD was well established. Streptococcal infectious diseases, such as group A streptococcal pharyngeal tonsillitis, SF, impetigo, and obstructive sleep apnea syndrome, were associated with the occurrence of ARF and RHD. ARF and RHD were still prevalent in young people of developing countries and economically poor populations of high-income countries. Universal disease registration systems were critical to locating disease outbreaks, tracking disease transmission, and identifying high-risk populations. Four-level prevention strategies were effective in reducing the incidence and mortality of ARF and RHD.ConclusionsRegistry and preventive measures for ARF and RHD should be strengthened in areas of dense population; poor sanitation; resurgence of SF; and high incidence of streptococcal pharyngitis, impetigo, and obstructive sleep apnea syndrome.

Group A Streptococcus Pili—Roles in Pathogenesis and Potential for Vaccine Development

“…The greatest burden is attributed to rheumatic heart disease (RHD), which often develops after acute rheumatic fever (ARF), with a global prevalence of approximately 15 million [ 69 , 71 ]. Although ARF and RHD rates have generally been decreasing in most parts of the developed world, they remain high in low-income countries [ 72 ]. In addition, disproportionally high rates of ARF and RHD continue to be reported in specific populations in higher-income countries, for example, the indigenous peoples of New Zealand and Australia [ 73 , 74 ].…”

Febre Reumática: Uma Revisão Da Literatura

“…A manifestação é tardia (1 a 2 semanas após as outras manifestações), regride rapidamente com o início do tratamento da cardite e não persiste por mais de 1 mês. (LIANG et al, 2023) 10 DIAGNÓSTICO O diagnóstico da febre reumática é clínico, não existindo sinal patognomônico ou exame específico. Os Critérios de Jones, estabelecidos em 1944 (última revisão em 2015 pela American Heart Association), continuam sendo considerados o padrão-ouro para o diagnóstico da FRA.…”

The Immunomodulatory Role of Microbiota in Rheumatic Heart Disease: What Do We Know and What Can We Learn from Other Rheumatic Diseases?

“…Rheumatic heart disease (RHD) is a serious cardiac sequela of acute rheumatic fever that can result in cardiac failure and valvular damage in children and young adults [ 1 ]. Rheumatic fever remains a significant healthcare burden in low- and middle-income countries [ 2 ]. Pharyngeal infection with beta-hemolytic group A streptococcal bacteria causes a systemic inflammatory response 2–3 weeks after the infection, which subsequently damages the tissues of several organs, especially the heart, joints, brain, and skin [ 3 ].…”