Rheumatic fever - information sheet - English - HE8168

Rheumatic fever is a serious illness that can cause major damage to your heart. A sore throat is often the first warning sign to watch out for. The illness mostly affects people aged between 3 and 35 years old.

Living with someone who has rheumatic fever means you have a higher risk of getting it too.

Contact your GP, doctor, hauora or healthcare provider, or call Healthline free on 0800 611 116 anytime 24/7 if anyone in your household aged 3 to 35 years develops a sore throat.

Seek health advice every time this happens because the infection that causes rheumatic fever can keep coming back.

Although a sore throat is often the first warning sign, rheumatic fever can also:

• damage the heart.
• cause pain in knees, ankles, elbows or other joints.
• cause unusual hand or arm movements.

If a person gets rheumatic fever, it may cause permanent damage to their heart valves. This is called rheumatic heart disease. People with rheumatic fever or rheumatic heart disease need to have antibiotic injections every 28 days (four weeks) for at least 10 years, to prevent rheumatic fever from happening again, and to stop further damage to the heart. Sometimes people with rheumatic fever end up needing heart surgery.

What causes rheumatic fever

Rheumatic fever is triggered by a germ called Group A Streptococcus or “strep”.

This germ can live in your throat without you having any symptoms, but in some people, it can cause a sore throat or a throat infection (known as strep throat).

Sometimes people with strep throat go on to develop rheumatic fever. It’s important to seek treatment for sore throats early, to help prevent the spread of the strep bacteria.

Some research suggests strep skin infections may possibly be linked to rheumatic fever, but it’s not yet clear if they cause it.

Signs and symptoms – What you can see and feel

Seek treatment for sore throats early

A sore throat is the main symptom of strep throat. In children, signs of a sore throat can include them finding it hard to swallow or having trouble eating or drinking.

Look out for symptoms of rheumatic fever

Not everyone who gets strep throat develops rheumatic fever.

People who develop rheumatic fever also get the following symptoms, around one to five weeks after having a sore throat.

• Sore joints – this is the most common symptom of rheumatic fever. Joints may be red, swollen and feel hot. This includes the hips, knees, elbows, ankles and wrists. Different joints may be sore on different days. Sore joints may cause a limp or difficulty walking because of pain.
• Shortness of breath — they may feel short of breath more easily than usual when exercising.
• A rash.
• Small painless lumps under the skin over the elbows, wrists, knees, ankles or spine.
• Unusual jerky movements of hands, feet, tongue and face. This can look like fidgeting or being unable to sit still and can affect handwriting. The movements stop during sleep.

Tamariki (children) and rangatahi (young people) may also have:

• tummy pains
• weight loss
• extreme tiredness
• an ongoing fever of 38°C or higher that lasts a few days.

Over time, most of these symptoms will go away. But heart damage can be permanent.

Seeking health advice

If you or anyone in your household aged 3 to 35 years has a sore throat, contact your GP, doctor, hauora or healthcare provider, or call Healthline free on 0800 611 116 anytime 24/7.

Your healthcare provider may want to do some tests for strep, and you or your household members may be given a course of antibiotics. Taking the antibiotics can help prevent you or others in your household from getting rheumatic fever.

People can get rheumatic fever more than once, so it’s important to get sore throats checked every time they occur.

Your doctor may also want to check If you have a skin infection from the strep germ and treat it with antibiotics. Strep skin infections may cause:

• itchy red skin with blisters that crust and scab (usually around the nose, mouth or legs), or
• redness, warmth, swelling and tenderness, or painful skin.

Prevention

Strep can spread easily in households, especially when there are lots of people living and sleeping in the same rooms.

However, there are steps you can take to reduce the risk of strep spreading.

• Avoid sharing drink bottles, cutlery, food or chewing food to give to a baby. This can pass strep germs from one person to another.
• Avoid preparing food for others while unwell or if you have a skin infection if possible.
• Cover your mouth and nose when coughing or sneezing, throw away the tissue afterwards, and wash and dry your hands thoroughly with soap and water.
• Avoid having multiple people sleep in the same room or share beds if possible.

For more information:

• Visit the Health New Zealand | Te Whatu Ora website Rheumatic fever
• Free NZ Relay Services are available at New Zealand Relay Services if you are Deaf, hard of hearing, deafblind or have speech communication difficulties.
• Call Healthline on 0800 611 116, anytime 24/7 for free health advice and information about what to do next. You can choose to speak with a Māori clinician if you are calling between 8am and 8pm. Interpreter services and NZ Relay support are also available.
• For people living or visiting rurally, you can contact a doctor after hours at Ka Ora Telecare for free on 0800 2 KA ORA 0800 252 672 or Ka Ora Telecare
• A dedicated helpline for Disability support is available Monday to Friday, between 8.00 am and 5.00 pm. Call free on 0800 11 12 13 or text 8988 for help and information or visit Disability Helpline