Rheumatic Fever Week: Spotlighting the Disease's Impact on Women

Rheumatic fever is a preventable yet serious illness that can cause damage to the heart, joints, and brain. It is caused by a bacterial infection called strep throat, which can be treated with an antibiotic (penicillin).
 
In South Africa, Rheumatic Fever Week (1-7 August) falls in Women's Month. This is a timely opportunity to raise awareness of the disease's impact on women and to encourage those affected to take steps to protect their health. Women and children in lower income countries and communities are most affected by rheumatic fever and its complications. This is likely due to a few factors, including biological differences, social determinants of health, and access to healthcare.
 
The symptoms of rheumatic fever can include fever above 38°C, joint pain, a skin rash, generally feeling unwell, shortness of breath, and heart problems. If you experience any of these symptoms, it is important to see a doctor right away. Early diagnosis and treatment can help prevent serious complications. There is no cure for rheumatic fever, but it can be treated with antibiotics.  
 
One can experience a single episode or repeated episodes of rheumatic fever. Without antibiotic treatment, further damage to the heart and other organs can be incurred. Permanent damage to the heart valves is known as rheumatic heart disease (RHD), which can lead to stroke, heart failure, and even premature death. RHD requires life-long medication, medical surveillance and often surgery to repair or replace the affected heart valve(s).
 
Rheumatic Heart Disease and Pregnancy
 
RHD can have a significant impact on pregnancy. For girls and women of reproductive age who have been diagnosed with RHD, it is important to be aware of the risks and take steps to manage their health.
 
During pregnancy, the heart needs to work much harder due to increased blood volume and cardiac output. This can put extra strain on the heart valves, which are compromised in people with RHD. As a result, women with RHD are at increased risk of heart failure, preterm birth, and other complications during pregnancy and delivery.
 
Symptoms of heart failure during pregnancy can include breathlessness, fatigue, swelling, and heart murmurs. These symptoms may be mistaken for normal signs and symptoms of late pregnancy, so it is important to see a doctor if you experience any of them.
 
If you have RHD and are considering pregnancy, it is important to talk to your doctor about your risks and how to manage your health. You may need to take medication to prevent heart failure, and you may need to have more frequent prenatal visits at a cardio-obstetric clinic.
 
Seeking Medical Attention
If you develop symptoms of rheumatic fever or rheumatic heart disease, it is important to seek medical attention immediately. For women, it is also critical to speak with a health provider about family planning. If you are already pregnant and experiencing any of the symptoms listed above, you should seek medical attention.
 
Take Home Message
Rheumatic fever and rheumatic heart disease can be serious conditions, but they can be managed with proper care. If you have been diagnosed with either of these conditions, it is important to be aware of the risks and take steps to manage your health. By working with your doctor, you can safely have a healthy pregnancy.