Can a sore throat be a killer?

It’s winter.  Your child has a sore throat.  Probably nothing more than the common cold?  Not necessarily. 

Most children suffer from sore throats occasionally, but the bacteria that cause a sore throat, Streptococcus Group A, are also responsible for Rheumatic Fever, a serious condition which can recur and ultimately lead to permanent heart valve damage, then termed Rheumatic Heart Disease, a major cause of death worldwide.

Dr Vash Mungal-Singh, CEO of the Heart and Stroke Foundation of South Africa (HSFSA) comments, ‘A sore throat, often called a ‘strep throat’, if left untreated can lead to Rheumatic Fever (RF).  With repeated attacks of untreated RF, damage to the heart valves occurs and this is known as Rheumatic Heart Disease (RHD).  RHD is serious and dramatically affects quality of life, very often requiring open-heart surgery to repair or replace damaged valves. Sadly, 60% of all acute rheumatic fever cases will develop into RHD, yet this is a preventable disease - as long as strep sore throats are treated.‘

Rheumatic Fever is most prevalent in children aged 5 to 15 and thrives in poor areas where sanitation is below par.  Sub-Saharan Africa is no exception and RF is rife.  On the upside, the disease can be treated easily and cost-effectively with penicillin, which is readily available.  

So what should parents look out for?  According to Dr Vash, RF occurs somewhere between 2 and 4 weeks after an untreated strep throat (characterised by sore throat, pain when swallowing, swollen glands, and the absence of flu-symptoms).  The symptoms of RF include tiredness, shortness of breath, sore joints, a rash and bumps under the skin.

Dr Vash continues, ‘If you suspect that your child has strep throat or RF, take him or her to a doctor or clinic immediately.  The treatment is quick, cheap and very effective.  The message we want to drive home is that RHD is preventable.  Globally, it is one of the leading forms of heart disease in children and young people.  It is far more prevalent in poor countries.’ 

According to Dr Liesl Zühlke, a paediatric cardiologist at Red Cross Children’s Hospital and a researcher with the University of Cape Town,  acute rheumatic fever and RHD affect about 15.6 million people worldwide (with approximately 350 000 deaths annually), 2.4 million of whom are children between five and fourteen years old in developing countries.

In response, South Africa has established the A.S.A.P. Programme (Awareness, Surveillance, Advocacy and Prevention), headed by Prof Bongani Mayosi of UCT, to help reduce the burden of RHD in children on the continent. Mark Engel, PhD research fellow at UCT and the co-ordinator of the programme, explains that the programme, amongst others, aims to raise public and health professional awareness of RHD, document the prevalence and eventually eradicate the disease within Africa. “RHD is a serious health problem in Sub-Saharan countries and it became clear that we needed to do something ourselves to try to eradicate this disease,” says Mr Engel.

Dr Vash concludes, ‘If parents are vigilant about sore throats and have their children treated quickly, we can eradicate this scourge and literally save millions of lives. Wealthier countries have been successful in this regard. What we need is awareness in South Africa, so I am appealing to all parents and carers to take the time to understand the symptoms of RF and seek treatment timeously before RHD develops. The Heart and Stroke Foundation South Africa (HSFSA) fully supports the A.S.A.P team and will continue to do so in an attempt to save as many little hearts from future heartache’.

The HSFSA is a not-for-profit organisation dedicated to reducing the incidence of cardiovascular disease through education.  For more information please visit www.heartfoundation.co.za, email heart@heartfoundation.co.za or call the Heart Mark Diet Line on 0860 223 222

For more information on the A.S.A.P. Programme, please visit www.pascar.co.za or contact Mark Engel on mark.engel@uct.ac.za or 021 406 6200.