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(New page: {{Rheumatic fever}} {{CMG}}; Lance Christiansen, D.O.; '''Associate Editor(s)-in-Chief:''' {{CZ}} ==Epidemiology and Demographics== '''Rheumatic fever''', and therefore Streptococus pyoge...)
 
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==Overview==
The [[incidence]] of rheumatic fever among developed countries such as the USA and Canada was approximately 20-40 per 100,000 individuals between 1970-1990 with rheumatic heart disease occurring sporadically. Over past two decades, the [[prevalence]] of rheumatic fever has decreased to 5-20 per 100,000 individuals in Canada and <5 per 100,000 individuals in the USA with no new cases of rheumatic heart disease.


==Epidemiology and Demographics==
==Epidemiology and Demographics==
'''Rheumatic fever''', and therefore Streptococus pyogenes infections, are endemic in all areas of the world. In countries affected by the industrial revolution, domestic living conditons became less crowded, due to the development of larger homes and families had fewer children. In addition, iving conditions became, generally, more hygienic. The introduction of antibiotics, first sulfonamide in the early 1930's and then penicillin in the 1940's, further caused Streptococcus pyogenes infections to become less common and less severe in economically developed countries although they never disappeared.
===Prevalence===
Between 1990 and the present, the [[prevalence]] of rheumatic fever has decreased to 5-20 per 100,000 individuals in Canada and <5 per 100,000 individuals in the USA with no new cases of rheumatic heart disease.<ref name="pmid21386976">{{cite journal| author=Seckeler MD, Hoke TR| title=The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. | journal=Clin Epidemiol | year= 2011 | volume= 3 | issue=  | pages= 67-84 | pmid=21386976 | doi=10.2147/CLEP.S12977 | pmc=PMC3046187 | url= }} </ref> More information regarding [[prevalence]] of rheumatic fever can be found [http://www.who.int/cardiovascular_diseases/resources/en/cvd_trs923.pdf '''here'''.]
===Incidence===
Between 1970-1990, the [[incidence]] of rheumatic fever among developed countries such as the USA and Canada was approximately 20-40 per 100,000 individuals between 1970-1990 with rheumatic heart disease occurring sporadically. More information regarding [[incidence]] of rheumatic fever can be found [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046187/ '''here'''.]


Rheumatic fever was a scorge of society for hundreds of years, until the post WW II era, for in the text, ''Rheumatic Fever and Streptococcal Infection'' (Massell, B., Harvard Press, 1997)the author indicates, "For the period 1939-1943, statistics published by the Metropolitan Life Insurance Company indicated that rheumatic fever was the leading cause of death among policy holders for persons from five to nineteen  years of age and the second leading fatal disease among twenty to twenty-four year olds."
===Age===
Rheumatic fever tends to affect a younger age group, generally between the ages of 5-15.<ref name="pmid8440039">{{cite journal| author=Grover A, Dhawan A, Iyengar SD, Anand IS, Wahi PL, Ganguly NK| title=Epidemiology of rheumatic fever and rheumatic heart disease in a rural community in northern India. | journal=Bull World Health Organ | year= 1993 | volume= 71 | issue= 1 | pages= 59-66 | pmid=8440039 | doi= | pmc=PMC2393425 | url= }} </ref> [[Group A beta-hemolytic streptococci|Group A beta-hemolytic streptococcus]] [[pharyngitis]] is uncommon in [[children]] less than 3 years of age, and rheumatic fever is extremely rare. Rheumatic fever among adults is less frequent and accounts for approximately 20% of cases.


In north America, western Europe, Japan, much of Australia and New Zealand rheumatic fever became very uncommon. It decreased in frequency in modern western societies in a progressive fashion from the early 1900's, but it decreased remarkably after WW II so by 1970 it was thought to be a very rare disease in the USA, for instance, but it never disappeared. In certain populations such as the aboriginies of Austrialia and New Zealand it remained common and it also remained common in the aborigines of North America although it is not mentioned frequently in medical literature.
===Gender===
No predilection towards either gender exists. However, certain manifestations of rheumatic fever such as [[mitral valve prolapse]], [[carditis]], and [[Sydenham chorea]] are commonly often observed among [[females]] than [[males]].<ref>Bisno AL. Rheumatic fever. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 313</ref>


Rheumatic fever affects individuals who are thought to be "young and healthy", for instance, individuals between four years and fifty years of age, but during most eras rheumatic fever was most commonly noted in individuals between the six and thirty. The reason children younger than four years of age, or so, do not ''usually'' develop rheumatic fever is that an individual must have sufficient, prior stimulation by Streptococcus pyogens autoantigens, which is, typically, caused by multiple infections by Streptococcus pyogenes, over a relatively short period of time, and that situation is ''less likely'' to occur in younger children (although it does happen!). Older individuals are expected, somewhat, to develop diseases of aging and so it is often not surprising when they become sick; it is surprising when individuals in their teens, twenties, thirties, forties and even fifties, for instance, become very sick so those cases attract more "medical" attention. Individuals of all ages, however, can develop rheumatic fever.  
===Developed Countries===
The [[incidence]] of rheumatic fever among developed countries such as the USA and Canada was approximately 20-40 per 100,000 individuals during the period 1970-1990 with rheumatic heart disease occurring sporadically. Over past two decades, the [[prevalence]] of rheumatic fever has decreased to 5-20 per 100,000 individuals in Canada and <5/100,000 individuals in the USA with no new cases of rheumatic heart disease.<ref name="pmid21386976">{{cite journal| author=Seckeler MD, Hoke TR| title=The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. | journal=Clin Epidemiol | year= 2011 | volume= 3 | issue=  | pages= 67-84 | pmid=21386976 | doi=10.2147/CLEP.S12977 | pmc=PMC3046187 | url= }} </ref> The [[incidence]] of rheumatic fever among developed nations is low, likely due to improved [[Hygiene|hygienic]] standards and routine use of [[antibiotics]] for [[acute pharyngitis]].<ref name="pmid17766522">{{cite journal| author=Miyake CY, Gauvreau K, Tani LY, Sundel RP, Newburger JW| title=Characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever. | journal=Pediatrics | year= 2007 | volume= 120 | issue= 3 | pages= 503-8 | pmid=17766522 | doi=10.1542/peds.2006-3606 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17766522  }} </ref>
 
===Developing Countries===
The rates of rheumatic fever and [[Rheumatic heart disease|rheumatic heart diseases]] among developing nations have mixed trends. Recently, the [[incidence]] rate of rheumatic fever has decreased in India, China, and African countries, which has been mainly attributed to improved access to [[medical]] treatment. This has led to improved [[Survival rate|survival rates]] even among individuals with [[rheumatic heart disease]]. As a result, an increase in [[prevalence]] rate has been observed.<ref name="pmid21386976">{{cite journal| author=Seckeler MD, Hoke TR| title=The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. | journal=Clin Epidemiol | year= 2011 | volume= 3 | issue=  | pages= 67-84 | pmid=21386976 | doi=10.2147/CLEP.S12977 | pmc=PMC3046187 | url= }} </ref> Newer studies relying on [[echocardiography]] in the [[diagnosis]] of rheumatic heart disease have demonstrated that rates of subclinical [[carditis]] are up to 10x higher than that [[Diagnosis|diagnosed]] by [[clinical examination]].<ref name="pmid17671255">{{cite journal| author=Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D et al.| title=Prevalence of rheumatic heart disease detected by echocardiographic screening. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 5 | pages= 470-6 | pmid=17671255 | doi=10.1056/NEJMoa065085 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17671255  }} </ref><ref name="pmid20345448">{{cite journal| author=Bhaya M, Panwar S, Beniwal R, Panwar RB| title=High prevalence of rheumatic heart disease detected by echocardiography in school children. | journal=Echocardiography | year= 2010 | volume= 27 | issue= 4 | pages= 448-53 | pmid=20345448 | doi=10.1111/j.1540-8175.2009.01055.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20345448  }} </ref><ref name="pmid18952636">{{cite journal| author=Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A et al.| title=Prevalence of rheumatic heart disease in school children of urban Lahore. | journal=Heart | year= 2009 | volume= 95 | issue= 5 | pages= 353-7 | pmid=18952636 | doi=10.1136/hrt.2008.143982 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18952636  }} </ref><ref name="pmid18398402">{{cite journal| author=Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ et al.| title=Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren. | journal=Nat Clin Pract Cardiovasc Med | year= 2008 | volume= 5 | issue= 7 | pages= 411-7 | pmid=18398402 | doi=10.1038/ncpcardio1185 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18398402  }} </ref> India, Pakistan, Russia, and African countries have higher [[prevalence]] rates of [[rheumatic heart disease]]. It is estimated that approximately there are 62-78 million [[rheumatic heart disease]] patients worldwide, which could potentially result in 1.4 million deaths per year.<ref name="pmid20538135">{{cite journal| author=Paar JA, Berrios NM, Rose JD, Cáceres M, Peña R, Pérez W et al.| title=Prevalence of rheumatic heart disease in children and young adults in Nicaragua. | journal=Am J Cardiol | year= 2010 | volume= 105 | issue= 12 | pages= 1809-14 | pmid=20538135 | doi=10.1016/j.amjcard.2010.01.364 | pmc=PMC2895982 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20538135  }} </ref><ref name="pmid16253886">{{cite journal| author=Carapetis JR, Steer AC, Mulholland EK, Weber M| title=The global burden of group A streptococcal diseases. | journal=Lancet Infect Dis | year= 2005 | volume= 5 | issue= 11 | pages= 685-94 | pmid=16253886 | doi=10.1016/S1473-3099(05)70267-X | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16253886  }} </ref> Occurrence  of rheumatic fever is associated with low socioeconomic and over crowded conditions.


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
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[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Infectious disease]]
[[Category:Rheumatology]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Epidemiology]]
{{WH}}
{{WS}}

Latest revision as of 00:00, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Lance Christiansen, D.O.; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S. [3]; Anthony Gallo, B.S. [4]

Overview

The incidence of rheumatic fever among developed countries such as the USA and Canada was approximately 20-40 per 100,000 individuals between 1970-1990 with rheumatic heart disease occurring sporadically. Over past two decades, the prevalence of rheumatic fever has decreased to 5-20 per 100,000 individuals in Canada and <5 per 100,000 individuals in the USA with no new cases of rheumatic heart disease.

Epidemiology and Demographics

Prevalence

Between 1990 and the present, the prevalence of rheumatic fever has decreased to 5-20 per 100,000 individuals in Canada and <5 per 100,000 individuals in the USA with no new cases of rheumatic heart disease.[1] More information regarding prevalence of rheumatic fever can be found here.

Incidence

Between 1970-1990, the incidence of rheumatic fever among developed countries such as the USA and Canada was approximately 20-40 per 100,000 individuals between 1970-1990 with rheumatic heart disease occurring sporadically. More information regarding incidence of rheumatic fever can be found here.

Age

Rheumatic fever tends to affect a younger age group, generally between the ages of 5-15.[2] Group A beta-hemolytic streptococcus pharyngitis is uncommon in children less than 3 years of age, and rheumatic fever is extremely rare. Rheumatic fever among adults is less frequent and accounts for approximately 20% of cases.

Gender

No predilection towards either gender exists. However, certain manifestations of rheumatic fever such as mitral valve prolapse, carditis, and Sydenham chorea are commonly often observed among females than males.[3]

Developed Countries

The incidence of rheumatic fever among developed countries such as the USA and Canada was approximately 20-40 per 100,000 individuals during the period 1970-1990 with rheumatic heart disease occurring sporadically. Over past two decades, the prevalence of rheumatic fever has decreased to 5-20 per 100,000 individuals in Canada and <5/100,000 individuals in the USA with no new cases of rheumatic heart disease.[1] The incidence of rheumatic fever among developed nations is low, likely due to improved hygienic standards and routine use of antibiotics for acute pharyngitis.[4]

Developing Countries

The rates of rheumatic fever and rheumatic heart diseases among developing nations have mixed trends. Recently, the incidence rate of rheumatic fever has decreased in India, China, and African countries, which has been mainly attributed to improved access to medical treatment. This has led to improved survival rates even among individuals with rheumatic heart disease. As a result, an increase in prevalence rate has been observed.[1] Newer studies relying on echocardiography in the diagnosis of rheumatic heart disease have demonstrated that rates of subclinical carditis are up to 10x higher than that diagnosed by clinical examination.[5][6][7][8] India, Pakistan, Russia, and African countries have higher prevalence rates of rheumatic heart disease. It is estimated that approximately there are 62-78 million rheumatic heart disease patients worldwide, which could potentially result in 1.4 million deaths per year.[9][10] Occurrence of rheumatic fever is associated with low socioeconomic and over crowded conditions.

References

  1. ↑ 1.0 1.1 1.2 Seckeler MD, Hoke TR (2011). "The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease". Clin Epidemiol. 3: 67–84. doi:10.2147/CLEP.S12977. PMC 3046187. PMID 21386976.
  2. ↑ Grover A, Dhawan A, Iyengar SD, Anand IS, Wahi PL, Ganguly NK (1993). "Epidemiology of rheumatic fever and rheumatic heart disease in a rural community in northern India". Bull World Health Organ. 71 (1): 59–66. PMC 2393425. PMID 8440039.
  3. ↑ Bisno AL. Rheumatic fever. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 313
  4. ↑ Miyake CY, Gauvreau K, Tani LY, Sundel RP, Newburger JW (2007). "Characteristics of children discharged from hospitals in the United States in 2000 with the diagnosis of acute rheumatic fever". Pediatrics. 120 (3): 503–8. doi:10.1542/peds.2006-3606. PMID 17766522.
  5. ↑ Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D; et al. (2007). "Prevalence of rheumatic heart disease detected by echocardiographic screening". N Engl J Med. 357 (5): 470–6. doi:10.1056/NEJMoa065085. PMID 17671255.
  6. ↑ Bhaya M, Panwar S, Beniwal R, Panwar RB (2010). "High prevalence of rheumatic heart disease detected by echocardiography in school children". Echocardiography. 27 (4): 448–53. doi:10.1111/j.1540-8175.2009.01055.x. PMID 20345448.
  7. ↑ Sadiq M, Islam K, Abid R, Latif F, Rehman AU, Waheed A; et al. (2009). "Prevalence of rheumatic heart disease in school children of urban Lahore". Heart. 95 (5): 353–7. doi:10.1136/hrt.2008.143982. PMID 18952636.
  8. ↑ Carapetis JR, Hardy M, Fakakovikaetau T, Taib R, Wilkinson L, Penny DJ; et al. (2008). "Evaluation of a screening protocol using auscultation and portable echocardiography to detect asymptomatic rheumatic heart disease in Tongan schoolchildren". Nat Clin Pract Cardiovasc Med. 5 (7): 411–7. doi:10.1038/ncpcardio1185. PMID 18398402.
  9. ↑ Paar JA, Berrios NM, Rose JD, Cáceres M, Peña R, Pérez W; et al. (2010). "Prevalence of rheumatic heart disease in children and young adults in Nicaragua". Am J Cardiol. 105 (12): 1809–14. doi:10.1016/j.amjcard.2010.01.364. PMC 2895982. PMID 20538135.
  10. ↑ Carapetis JR, Steer AC, Mulholland EK, Weber M (2005). "The global burden of group A streptococcal diseases". Lancet Infect Dis. 5 (11): 685–94. doi:10.1016/S1473-3099(05)70267-X. PMID 16253886.

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