Rheumatic heart disease has been all but eliminated in wealthy countries. It is still common in ours — not because it is hard to prevent, but because a treatable sore throat went untreated.
The chain runs like this: an untreated streptococcal throat infection leads to rheumatic fever, which scars the heart valves, which becomes lifelong heart disease. It is broken at step one, with an assessment and a completed course of antibiotics.
What strep throat looks like
Not every sore throat is strep, and not every sore throat needs antibiotics. The pattern worth taking seriously in a child is:
- A severe sore throat, with fever
- Pain on swallowing
- Swollen, tender glands in the neck
- White patches or spots on the tonsils
- Often no cough and no runny nose — that combination is what distinguishes it from an ordinary viral throat
A throat swab settles it. Our Pathology department, run on site by Ampath Laboratory, processes throat swabs so treatment can start on the right footing.
Warning signs of rheumatic fever
Rheumatic fever typically appears one to five weeks after a sore throat. Bring your child in the same day if you see:
- Fever with sore, swollen, painful joints — often moving from one joint to another
- A rash, or painless lumps under the skin
- Unusual jerky, uncontrolled movements
- Shortness of breath, chest pain or unusual tiredness
The link to the earlier sore throat is easy to miss because weeks have passed. Mention it.
Prevention
Timely assessment of a bad sore throat, and finishing the full course of antibiotics if they are prescribed — even once your child feels better after two days. Stopping early is how the chain stays intact.
If damage has already occurred
Valve disease can be monitored and managed medically, and repaired or replaced surgically where needed. It is not a diagnosis without options.
How we help
- Paediatrics — assessment and treatment of strep throat, and of a child who is unwell after one. Dr. NN Gibango, Dr. JN Mathibedi, Dr. I Tshetlo and Dr. DL Kutumela.
- Ear, Nose & Throat — recurrent tonsillitis, with Prof. Dr. M Tshifularo and Dr. M Kotu.
- Pathology — throat swabs and blood tests on site through Ampath Laboratory.
- Cardiothoracic Surgery and Physicians — heart valve disease, with Dr. SM Mazibuko.
- Emergency & Trauma Unit — open 24 hours on 012 798 7076 if your child is struggling to breathe or swallow.
A child with a bad sore throat and fever should be seen — 012 798 7000.
