Do You Know Enough About Rheumatic Fever?

A specialist physician: Dr. Mastern answers mothers' questions on this subject

Q — Several cases of rheumatic fever have occurred in our neighborhood, among the victims a boy of three and a man of twenty. What are the symptoms of this disease?

A — The first symptoms of this disease are pain in the throat, high fever, and aching in the joints, often accompanied by a skin rash and pain in the bowels; sometimes among the first signs of this disease is nosebleed. The cause of the disease is the entry of the streptococcus microbe into the body by way of the mouth and throat, and some persons are more susceptible to it than others. This microbe roams in the blood and injures the heart, leaving it weak for life.

Q — What precautions must I take to protect my children from rheumatic fever??

A — To protect your children against this microbe, you must call the doctor as quickly as possible whenever they feel a sharp pain in the throat with high fever. If the doctor finds that the rheumatic-fever microbe is the cause of the fever, he will of course prescribe penicillin and sulfa, for this treatment is very beneficial if taken regularly.

Q — Is rheumatic fever a dangerous disease? Most of us fear infantile paralysis more than it.

A — Rheumatic fever is in truth among the most dangerous diseases of childhood. Our grandfathers called it inflammation of the joints, and it carried off most of its child victims. Even in our own day, this disease kills far more children between the ages of five and nineteen than tuberculosis, infantile paralysis, and chest colds. About a million persons in the United States are stricken with this disease every year.

Q — May I give my child penicillin and sulfa when he has a heavy cold??

A — No. Only when the cause of the cold is the entry of the streptococcus microbe, and on the order of the doctor who has diagnosed the illness and prescribed the treatment.

Q — My child was stricken with rheumatic fever several years ago and recovered completely two years ago. Is that not time enough to put him safely beyond this disease??

A — No, he is not yet safe from this disease. Let the doctor see him and decide whether he had rheumatic fever or not. If his answer is yes, then your child must remain under medical attention and his heart must be examined; and even if the heart has escaped harm, it is better to keep up the examinations regularly. Most important of all is taking penicillin and sulfa always, to prevent the return of the deadly disease.

Q — For how long must penicillin and sulfa be taken??

A — For life — or until medicine has found a better way. This sentence will seem to you harsh and cruel, but remember that a heart ruined by the effects of this disease is far worse. The continuous taking of penicillin and sulfa is as necessary for rheumatic patients as insulin is for those suffering from diabetes.

Q — Some say that penicillin has bad effects, among them skin rash. Is this true, and is there any danger in it??

A — No. Penicillin holds no danger for the body if it is given under the supervision of a doctor who knows how to regulate the doses and who watches for the first signs of sensitivity. The bad results of penicillin rarely occur, except sometimes when it is taken by mouth; the disturbances of frequent occurrence come from taking sulfa. It causes a skin rash, destroys the white corpuscles of the blood, and injures the kidney; because of these dangers, patients who take sulfa must have their urine and blood examined regularly.

Q — I know a family that gives its child, who was stricken with rheumatic fever, doses of penicillin by mouth every day, while in another family the child takes penicillin by injection once a month. Why this difference??

A — Both ways of taking the medicine are beneficial, but injections are surer, for children forget to take their pills and must always be reminded. Parents bear a great responsibility in looking after the health of their child without making him feel that he is sick; rather, this permanent treatment must become second nature to him, without the medicine becoming the pivot of his thoughts.

Q — What is the usefulness of aspirin in cases of rheumatic fever??

A — Aspirin has proved to be among the safe and useful medicines for the relief of rheumatic-fever sufferers, as much as any other treatment; but it only relieves the symptoms and the pains, and does not kill the streptococcus microbe.

Q — Is rheumatic fever a hereditary disease??

A — The disease in itself is not hereditary, but families in which several persons have been stricken with it must keep to the side of caution and care.

Q — Is this disease contagious??

A — A child who carries the streptococcus microbe in his nose and throat can pass the infection to others exactly like a cold. Therefore, if you learn that your child has been in contact with a child previously stricken with this disease, consult your doctor at the first slight cold.

Q — My child is fortunately among those who have been cured of rheumatic fever, because we hastened to take the necessary precautions and medicines when he fell ill two years ago, and since then he has kept up taking penicillin regularly. Can you tell me whether there is any danger of the disease returning if his tonsils are removed?

A — No, not necessarily; but the doctor must be told that your child was stricken with rheumatic fever, so that he may use a certain quantity of penicillin before and after the operation, lest the disease return to him. This must also be applied when molars are extracted, so the dentist must be informed in advance.

Q — If the medicines are of sure benefit in helping and curing those stricken with rheumatic fever, why does my little girl's heart not improve, though she keeps up taking penicillin regularly?

A — These medicines, unfortunately, do not ward off the consequences of this deadly disease; the reason for taking penicillin now is to remove the possibility of the disease's returning again. Your little girl must remain under the watch of a specialist in heart disease, under whose supervision her heart can improve, and it is he who will guide you as to the physical activity she may undertake.