With interest, we read the article by Hajar[1] “Rheumatic Fever and Rheumatic Heart Disease: A Historical Perspective.’’ We want to correct the mistake associated with the prevalence of rheumatic heart disease in this article. There was a mistake in Table 2 called “Summary of the American Heart Association revised 2015 Jones criteria.” The statement “Low‐risk population: Acute rheumatic fever (...

Rheumatic heart disease, already a major burden in low- and middle-income countries, is becoming an emerging problem in high-income countries. Although acute rheumatic fever and rheumatic heart disease have almost been eradicated in areas with established economies, the emergence of this problem may be attributable to the migration from low-income to high-income settings. Between 2010 and 2012,...

BACKGROUND The reason why some individuals but not others are susceptible to rheumatic fever and chronic rheumatic heart disease is not understood. Because of the substantial evidence that poverty is an important determinant of the disease and must operate in early life, we have investigated the role of the early environment in an ecological study using 20(th) century mortality as an index of d...

BACKGROUND The incidence of rheumatic heart disease is great in Brazil. We analyzed the distribution of human leukocyte (HLA) antigens in a Brazilian population sample with rheumatic fever or rheumatic heart disease, with the aim of better understanding the mechanisms involved. METHODS AND RESULTS HLA class I (A, B, and C) and class II (DR and DQ) antigen distribution was studied in 40 patien...

BACKGROUND Epidemiologic studies of the prevalence of rheumatic heart disease have used clinical screening with echocardiographic confirmation of suspected cases. We hypothesized that echocardiographic screening of all surveyed children would show a significantly higher prevalence of rheumatic heart disease. METHODS Randomly selected schoolchildren from 6 through 17 years of age in Cambodia a...

439 O 30 or 40 years ago, rheumatic fever was a common topic in the Journal. A PubMed search for articles on rheumatic fever published between 1967 and 1976 returned 55 New England Journal of Medicine articles — fewer than for endocarditis (77) but more than for stroke and syphilis (24 entries each). A similar PubMed search for the decade 1997 through 2006 yielded just eight entries for rheumat...

Rheumatic heart disease, often neglected by media and policy makers, is a major burden in developing countries where it causes most of the cardiovascular morbidity and mortality in young people, leading to about 250,000 deaths per year worldwide. The disease results from an abnormal autoimmune response to a group A streptococcal infection in a genetically susceptible host. Acute rheumatic fever...

Rheumatic fever and rheumatic heart disease continue to be major public health problems in the developing world, particularly in the countries of sub-Saharan Africa. Because of its cost effectiveness, secondary prophylaxis is advocated as the principal means of disease prevention and control. However, in developing countries, valvular damage, due to earlier, unrecognized episodes of rheumatic f...