Rheumatic fever 

Rheumatic fever is a serious complication that can develop following an untreated throat infection (by a type of bacteria called streptococcus). It's uncommon in the UK.

The symptoms of rheumatic fever include:

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

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 strep bacteria which causes parts of the body to become inflamed (swollen and filled with fluid). Triggering the symptoms of rheumatic fever.

Read more about the causes of rheumatic fever.

Treatment

There is currently no cure for rheumatic fever so treatment involves relieving symptoms with medication and trying to prevent permanent damage to the body, especially the heart (see below).

Once a person has an attack of rheumatic fever it is very common for them to have further attacks in the future. 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, which is known as rheumatic heart disease.

Rheumatic heart disease 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. There were only 23 reported cases in England during 2010.

Most cases of rheumatic fever first develop in children aged 5-15. 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 experienced significant damage to the heart.

If the heart is damaged then it is unlikely to fully recover, and the symptoms of rheumatic heart disease, such as shortness of breath and feeling tired all the time, will continue.

If the heart is undamaged, long-term use of antibiotics should prevent rheumatic fever from reoccurring which should prevent further damage to the heart.

Deaths associated with rheumatic heart fever are very rare in England and the rest of the developed world. In 2010 there were only 6 deaths related to rheumatic fever in England and Wales.