What are the Risk Factors for Rheumatic Fever?

Risk Factors for Rheumatic Fever: Causes & Complications Explained

Rheumatic fever develops after a streptococcal throat infection or scarlet fever. It can mainly affect the heart, skin, joints and brain, leading to long-term heart damage. Untreated throat infections are one of the key factors for developing rheumatic fever in children aged 5 to 15 years.

Risk Factors for Rheumatic Fever

Here, we will discuss some common risk factors for rheumatic fever. These include:

Untreated Strep Throat Infection

If strep throat is not treated with antibiotics, the bacteria can easily spread to other body parts, causing complications, like rheumatic fever. Even after proper treatment, an insufficient amount of antibiotics can allow the infection to persist, resulting in rheumatic fever.  

Living in Crowded Conditions

Overcrowding is a key factor in the development of rheumatic fever, as living in this type of environment can spread the infection. Living in crowded places promotes close contact and poor ventilation, promoting a suitable environment for the bacteria.   

Poor Sanitation

Poor sanitation and limited access to clean, hygienic water can promote the spread of bacteria. Little access to clean water facilitates the transmission of this pathogen from one person to another. This increases the risk of throat infection and eventually elevates the likelihood of the development of rheumatic fever.

Limited Access to Healthcare

Strep throat requires proper diagnosis and treatment to cure it permanently by consulting with healthcare providers. Residing in areas with limited access to healthcare facilities can increase the risk of worsening strep throat. Untreated strep throat can lead to rheumatic fever and, if left untreated, cause serious heart damage.       

Genetic Predisposition

Certain genes can influence an individual's susceptibility to develop autoimmune reactions after a strep throat infection. Components of MHC class II molecules, DR and DQ alleles on chromosome 6, regulate autoimmune disease in rheumatic fever. HLA-DR7 allele is frequently linked with rheumatic fever, in combination with the DQ allele.   

Family History

A history of rheumatic fever in the family increases the risk of developing this disease due to a combination of environmental and genetic factors. Children susceptible to sore throat and having a family history of rheumatic fever are at higher risk of developing rheumatic fever.

Immunocompromised Patients    

Patients with weakened immunity are at a higher risk of developing this disease, as it is an autoimmune disease which occurs due to an overreaction of the body’s immune system to a throat infection. In the case of an immunocompromised environment, it is difficult for the immune system to kill the Group A streptococcus bacteria, leading to a more severe and prolonged infection.  

Complications of Rheumatic Fever

Rheumatic fevers can lead to severe complications, causing damage to the heart valves, atrial fibrillation, and other complications. These include:

• Heart Valve Damage: In severe cases, rheumatic fevers can cause scarring of the heart valves, leading to stenosis or regurgitation.

• Heart Failure: Damaged heart valves can impair the heart’s capacity to pump blood effectively, leading to heart failure.

• Atrial Fibrillation: Rheumatic heart disease can increase the risk of atrial fibrillation, a case of irregular heartbeat, which can lead to a heart attack.

• Sydenham’s Chorea: It is a rare neurological disorder exhibiting symptoms such as involuntary jerky movements.

• Glomerulonephritis: In some cases, prolonged and persistent rheumatic fever can cause inflammation in the kidney tissues.  

Rheumatic fever can be managed effectively with proper treatment. It is crucial to seek prompt medical attention against a throat infection to prevent any kind of complications.