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- $Unique_ID{BRK00021}
- $Pretitle{}
- $Title{Is Rheumatic Fever Common Today?}
- $Subject{rheumatic fever fevers antibiotics Infection Infections streptococcal
- respiratory penicillin streptococci streptococcus erythromycin antibiotic lung
- lungs bronchi bronchioles}
- $Volume{A-5}
- $Log{
- Cross Section of a Lung*0005901.scf
- Anatomy of the Bronchial Tree*0005902.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
-
-
- Is Rheumatic Fever Common Today?
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-
- QUESTION: Is rheumatic fever as common today as when I was a child in the
- '20's?
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-
- ANSWER: By the 1970's, rheumatic fever was so rare in the United States, that
- few physicians actually saw a case of it. In the past three years, however,
- there has been a resurgence of the disease in various parts of the country, a
- puzzling occurrence that is not yet understood. Various theories are being
- explored to explain its recent return, but at the moment, none have been
- proven.
- Group A streptococcal infection in the upper respiratory tract is a major
- symptom of the disease, and by the late 1940's, medical researchers discovered
- that the fever could be prevented by treating patients who had the
- streptococcal infection with penicillin. As a result of this discovery,
- programs offering free throat culturing became popular nationwide. The link
- between the infection and the fever was widely publicized and antibiotic
- treatment was stressed.
- The near disappearance of rheumatic fever coincides with the time these
- programs were introduced, suggesting that the programs and the availability of
- antibiotic therapy aided in the decline. This conclusion can be further
- supported by the fact that in the early '80's the programs were suspended for
- cost considerations since the fever had become almost nonexistent.
- Though this data offers a partial explanation for the resurgence of the
- disease, it does not give us a totally effective answer to the problem since
- antibiotics alone have not removed the threat of the potentially fatal fever.
- Rheumatic fever has remained a continual threat in developing countries where
- medical treatment isn't as advanced as it is in our country, yet the outbreaks
- we are currently witnessing involve middle-class children who have access to
- excellent medical care. Furthermore, only a small percent of these patients
- show any evidence of respiratory infection. This leads experts to believe
- that the new outbreaks are being caused by a particularly potent strain of
- streptococcus that was not commonly encountered in the past. Another
- explanation can be the tolerance of group A streptococci to penicillin or the
- possibility of penicillin destruction by microorganisms in normal flora of the
- upper respiratory tract.
- Whatever the reasons, however, identifying and treating streptococci is
- still the clinical goal since the risk of developing the fever is reduced to
- practically zero when the infection is cured. An injection of IM benzathine
- penicillin every three to four weeks is the most effective therapy, though a
- 10-day oral dose of penicillin or erythromycin is very effective as well. In
- the long run, the most effective means for preventing future outbreaks will be
- the development of a successful vaccine. Researchers are currently making
- promising advances in this area, and in the near future, rheumatic fever will
- hopefully be a disease of the past once again.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-
-