What is rheumatic fever?

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HF5442 Rheumatic Fever A5 8/20/03 10:33 AM Page 2
What is
rheumatic
fever?

HF5442 Rheumatic Fever A5 8/20/03 10:33 AM Page 3
Information
for parents
This leaflet has been written to help
you understand more about Rheumatic
Fever and Rheumatic Heart Disease.
It answers questions you may have about:
• the illnesses
• the care and treatment your child will need
• how to prevent Rheumatic Fever attacks in the future
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What is Rheumatic Fever?
Rheumatic Fever is an illness. It often starts with a sore
throat (a streptococcal infection).
A few weeks after the “strep” throat your child may develop:
• sore or swollen joints (knees, elbows, ankles and wrists)
• a skin rash
• a fever
• stomach pain
• jerky movements
How can Rheumatic Fever Affect the Heart?
If your child has a bad attack of Rheumatic Fever it may
cause permanent damage to their heart valves. This is
called Rheumatic Heart Disease.
A heart valve acts like a one way door. It makes sure that
blood pumped by the heart flows in one direction only.
When the heart valve is
damaged it can cause:
• breathlessness
• tiredness
Heart
Valve

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Will these symptoms of Rheumatic Fever
go away?
Most of these acute symptoms such as; sore or swollen
joints (knees, elbows, ankles and wrists), a skin rash, a fever,
stomach pain and jerky movements will go away in time.
However damage to the heart valves, Rheumatic Heart
Disease, may be permanent.
What happens when my child is in hospital?
Your child will usually need to stay in hospital for 1-2 weeks,
but it is sometimes longer if their heart
is affected. They will have regular
examinations and blood tests to check
their condition. Sore joints can be
treated with rest and aspirin.
What if my child also has
Rheumatic Heart Disease?
If your child has damage to their heart valve they:
• may need to stay in hospital for longer
• have Penicillin injections for much longer
• will need special care when visiting the dentist
• may eventually need surgery to repair the damaged valve.
Your doctor or nurse will speak to you about the care and
treatment your child needs while they are in hospital.
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What care will my child
need at home?
Your child will still need to take it
easy when he or she goes home. They will also need to have
ongoing Penicillin injections to prevent another attack.
Another antibiotic, e.g Erythromycin will be given to people
who are allergic to Penicillin.
It is very important that your child does not get Rheumatic
Fever again. Another attack could cause long term
damage to the heart and heart valves.
How can I stop my child having another
attack of Rheumatic Fever?
The best way to stop your child having another attack of
Rheumatic Fever is to make sure they have regular Penicillin
injections.
Penicillin injections:
• must be given every 28 days
• are given in your child’s thigh
or bottom
• can be painful at first but children
quickly get used to them

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• are given by your Community Nurse, District Nurse or
Public Health Nurse. They will come to your home or your
child’s school and give the injection.
How long will my child need to have Penicillin
injections?
Your child will need to have injections for 10 years or until
they are 21 years old, whichever is longer.
This may seem like a long time but if your child doesn’t have
these injections they could have another Rheumatic Fever
attack.
Your doctor will tell you when it is safe for your child to stop
having the Penicillin injections.
What if my child misses or forgets an
injection?
It is very important that your child does not miss an
injection. If they do then you must arrange for them to get
the next injection as soon as possible.
Remember to tell your doctor
or nurse if:
• your child is going overseas,
on holiday, away for a while
or you are moving house.
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They can then arrange ongoing treatment for your child.
Your child should never stop Penicillin treatment without
discussing this first with your doctor.
Will my child be able to lead a normal life?
With proper care and regular Penicillin injections, most
children with Rheumatic Fever lead a normal life.
The important thing is to make sure your child never has
another attack of Rheumatic Fever. The only way you can do
this is to make sure they have their regular Penicillin
injections.

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What else do I need to do if my child has
Rheumatic Heart Disease?
You need to tell your child’s dentist.
It is very important to tell your dentist or dental nurse that
your child has Rheumatic Heart Disease because:
• your child will need extra antibiotics by mouth before any
dental treatment
When the dentist is working on your child’s teeth, tiny bugs
in the mouth (we all have them) can get into the blood
stream. The blood will carry these bugs to the heart and may
cause further damage to the heart valves. This is called
bacterial endocarditis.
An ‘Infective Endocarditis Prophylaxis’ Card
is available from your GP, Specialist or
the National Heart Foundation
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You need to help your child to look after their teeth and
avoid any infection.
Make sure that they:
• brush their teeth every day
• have dental checks every six months.
You need to tell your child’s doctor if they are having a
medical procedure.
There is an increased risk to them if they get an infection.
It is advisable to also avoid any body piercing or tattoos.
Your daughter will need to discuss contraception with
her doctor.
Your daughter may want to use contraceptives when she
is older. She should not use an IUD (intra-uterine device).
Oral contraceptives and condoms are recommended.
Ask your doctor about this.
Your daughter should also continue having Penicillin
injections during pregnancy until her doctor says they are
no longer needed.

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Other common questions and answers about
Rheumatic Fever
What happens when my child finishes having
injections?
Your doctor will tell you when it is safe for your child to stop
having the Penicillin injections.
When your child gets a sore throat, they will need to have a
check up to see if they have a “strep” throat. If they do, it
will have to be properly treated.
What about diet and Rheumatic Fever?
Because Rheumatic Fever can affect the heart, it is
important not to add further stress on the heart either by
smoking or being overweight.
To help your child, make
sure they eat a healthy diet.
Is Rheumatic
Fever catching?
You can not “catch” Rheumatic Fever from another person,
but “strep” throats can be passed on to others by breathing
or coughing over them.
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