Rheumatic Heart Disease: A Major Killer of Children
BY KRISTEN GARABEDIAN

emember the time you had strep throat as a kid? How much your throat hurt, how you had to go to the doctor and take medicine for over a week and stay home from school until you were better? That was no fun, to be sure, but if that's what happened to you when you caught strep throat as a child, you can consider yourself very fortunate. In the United States, strep throat is treated, and that's the end of the story.

For many children around the world, catching strep throat is the beginning of a deadly progression to rheumatic fever (RF) and ultimately rheumatic heart disease (RHD). Left untreated, strep throat can cause RHD: a severely damaging, often fatal illness for which there is no cure.

RHD is a major killer of children in developing countries. In fact, 15.6 million people globally suffer from rheumatic heart disease, with 233,000 deaths occurring each year because of RF or RHD.¹ Rheumatic heart disease is especially devastating to children and young adults in their most productive years.

Awareness of the relationship between strep throat and RHD is key. The good news is that RHD is preventable: If strep throat is identified and successfully treated in time, it means only a sore throat and a short period of medicine and rest for a child. Treated early, strep throat will not progress to RF and RHD.

Treating strep with antibiotics costs only pennies and takes around 10 days. Treating RHD can cost hundreds of thousands of dollars, and the treatment is not a cure but a maintenance regime that goes on for a lifetime—if treatment can be found. Even with proper treatment, death often results.

WiRED's RHD Training Module for Teachers

Teachers, who see children every day, play a critical part in the surveillance process for early lifesaving detection of strep throat. Parents and students also need to understand the potential dangers of a sore throat. (Not all sore throats are strep, but due to the serious risk factors they should be checked out by a doctor.)

Good community health stresses prevention. As a strong advocate of prevention, WiRED International is preparing a series of training modules to raise awareness and teach community members at the grassroots level how to recognize the signs and symptoms of strep throat and treat it before it progresses to RF and RHD. The modules also extensively cover the signs, symptoms, and treatment of RF and RHD, but the emphasis is on prevention since there is no cure once RF develops.

WiRED's RHD Training Module for Teachers

In this first round of training modules, we are directing messages to teachers and students. Modules for parents and community health workers will follow.

As WiRED prepares these modules, we are working with a group of pediatric cardiologists from several countries who are providing medical guidance. Modules will be distributed by international health organizations and by WiRED through our CHI Center facilities. We wish to thank The Medtronic Foundation for its generous funding of this important preventive effort.

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¹http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104525/, which cited as the primary source for these statistics: Carapetis JR, Steer AC, Mulholland EK, Weber M. The global burden of group A streptococcal disease. Lancet Infect Dis. 2005; 5:685–94.