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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Rheumatic fever epidemiology and demographics

Introduction

Overview

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

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

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.

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]