PREVENTION OF RHEUMATIC FEVER
The key to prevention
is the recognition of strep infections, especially when they cause sore throat
or tonsillitis. Early diagnosis by a doctor and prompt treatment with
penicillin or another antibiotic are most important, when a person has had
rheumatic fever once, everything possible must be done to prevent repeated
attacks because of the damage they may do to the heart. With proper care, most
people who have rheumatic fever will recover. With careful management, they can
avoid further attacks by avoiding strep infections.
By use of antibiotics or sulfa medicines, the strep
infections which cause recurrences can usually be controlled. Any child with
rheumatic fever or who has recovered from an attack should remain under the
care of a doctor or a heart clinic so that recurrences of this potentially
serious disease can be prevented. If this is done, these patients can lead
fully normal lives.
Heart Murmurs
Murmurs may be caused by changes in the heart valves and by
blood leaking from scarred valves which do not close properly. The idea of a
murmur usually frightens parents. Yet the fact is that there are innocent
murmurs which mean absolutely nothing. There are other murmurs which do not
come from heart conditions associated with rheumatic fever. And sometimes a
heart only very slightly affected by rheumatic fever may produce a loud murmur.
It is up to the physician and not the parents to decide when the heart is
healed and when a child may start playing and doing things those normal children
do. If there is any doubt, as there sometimes may be, consultation with a heart
specialist (a cardiologist) should be arranged.
Years ago when less was known
about rheumatic fever and such excellent laboratory tests as we have now were
not available, physicians used to advise a good deal of bed rest or very little
activity for people with heart murmurs. These people may have had mild
rheumatic fever. The bad psychological effect of such needless restriction was
worse than a mild impairment of the heart. If your child has had mild rheumatic
fever, don't coddle him or make him feel in any way that he is an invalid and
different from other children. See that he obtains plenty of rest, sunshine and
fresh air, and a good, nourishing diet.
This you should do for any child to
build up his resistance to germ diseases, but with the child who has had
rheumatic fever take special care, If he has had a severe illness and must have
his activities restricted, teach him not to overexert himself, but otherwise to
think and act like other children. The prevention of further streptococcal
infections is the prime measure, and your doctor can help advise you about
this. See your doctor for regular checkups of your children.
If a child should have undiscovered rheumatic fever, the
doctor can help you take proper precautionary steps against repeated attacks.