Science / Medicine : Rheumatic Fever on the Rise, Doctors Fear

Rheumatic fever appears to be making a strong comeback among children in several U.S. cities, and an expert attributes that to the emergence of dangerous strains of sore throat bacteria.

The outbreaks of rheumatic fever--which is caused by group A streptococcus bacteria, the germs responsible for strep throat--follow decades of steady decline.

“My hypothesis is that at least one of the factors related to the resurgence may be a change in the types of group A streptococcus that are prevalent” where the outbreaks have occurred, said Dr. Alan L. Bisno of the University of Miami School of Medicine.

The disease is of interest to heart specialists because its single lingering complication is heart damage, which affects about half of all victims.

Doctors are not required to report cases of rheumatic fever, but the American Heart Assn. estimates that in 1985, nearly 7,000 Americans died of the disease.

Since 1985, sizable outbreaks have been reported in several areas, including Salt Lake City, Pittsburgh and Columbus and Akron, Ohio. In the Utah cluster, the biggest of these, 138 cases have been diagnosed so far.

Finding the particular strain of bug responsible for the latest outbreaks is difficult. The disease’s symptoms usually do not appear until two to four weeks after a sore throat clears up. By then, the germ that caused the disease is gone.

However, doctors have isolated strep bacteria from friends and relatives of victims and assume that these may have caused the disease.

Doctors stress that parents should not ignore their children’s seemingly harmless sore throats.