Rheumatic heart disease (RHD) is a preventable, devastating condition that disproportionately affects Aboriginal and Torres Strait Islander Australians.
It is caused by a Group A Streptococcus (Strep A) bacterial infection of the throat and skin, which, without treatment, can result in permanent damage to the heart.
What causes Rheumatic Heart Disease (RHD)?
When a child gets a group A streptococcal infection of the throat (known as strep throat), their body’s immune system, in trying to fight that infection, produces antibodies. Sometimes these antibodies, in addition to killing the strep, can damage their heart. Acute rheumatic fever can occur following an untreated strep throat infection and can cause irreparable damage to the major cardiac valves, known as rheumatic heart disease.
How common is RHD?
RHD is considered a third-world disease yet Australia has some of the highest rates in the world. About 3-5 per cent of Aboriginal people living in remote and rural areas have the condition. Children aged between 5 and 14 years are most likely to get rheumatic fever.
What are the risk factors of RHD?
Certain living conditions make streptococcal infections more likely. Known risk factors include poverty, overcrowding and limited access to medical care. It is thought that the bacteria may also enter the body through skin cuts and abrasions - so skin sores in a child should never be ignored.
What are the symptoms?
Damaged heart valves found in RHD mean the heart cannot work normally. Symptoms include heart murmur, chest pain, breathlessness, and swelling of face and legs. RHD can result in heart failure and premature death.
How is it diagnosed?
Rheumatic fever is not a straightforward diagnosis - there’s no single test but rather a checklist of symptoms, including heart inflammation, fever, painful joints and skin rash. Early diagnosis and taking preventative antibiotics can stop it developing into RHD. People with RHD require ongoing medical care, antibiotic treatment and possibly cardiac surgery.
The only effective way to stop rheumatic fever recurring is to have monthly penicillin injections, for 10 years or until the patient has turned 21.
