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Hi, my name is Aunty Mary. I want to tell you a story about rheumatic heart disease, and how it has affected my family.

My nephew Michael is 10 years old. He has always been a fit and healthy boy. Michael enjoys school and loves to play football, and he is always running around. Last year he missed a lot of school and football, because he got sick with rheumatic heart disease. 

I want everybody to know my family’s story, so that we can stop our kids getting sick hearts, and stop rheumatic heart disease in our people.

What is acute rheumatic fever?

Acute rheumatic fever is a sickness caused by a germ called streptococcus, which is also known as ‘strep’. The strep germ can cause infections in the throat (sore throat) and on the skin (skin sores). Anyone can have these infections, but they are most common among children aged 5-14 years. After these strep infections go away, some people can get a sickness in other parts of the body.  This sickness is called acute rheumatic fever, and it can include

  • sore, red or swollen joints (knees, ankles, elbows, wrists)
  • a fever (feeling hot and cold)
  • a skin rash (on the body, arms and legs)
  • strange movements of the face, hands or feet, or difficulty walking
  • lumps under the skin (elbow, wrist, knees and ankles).

Children and young people with sore throats and skin sores, sore joints, fever, skin rashes or strange movements, should visit the clinic or hospital for tests. This is the only way to know for certain if it is acute rheumatic fever.

One day, Michael was sent home from school because he was complaining of pain in his knees and legs. He was limping, and it was hard for him to walk around. I was worried about Michael, because he had always been a fit and healthy boy.

I took him to the clinic to see the Health Worker. The Health Worker asked a lot of questions and checked Michaels blood pressure, heart rate and temperature. Michael had a fever and pain in his knees, and his heart was beating fast, so the Health Worker sent him to see the doctor. The doctor listened to my story about Michael, and he looked at Michael’s sore knees, checked his throat and skin, and listened to his heart.

The doctor sent Michael to the hospital. 

What happens with acute rheumatic fever?

People with acute rheumatic fever need to stay in hospital to have important blood tests and heart checks.

An ultrasound of the heart (echocardiogram) can show if there is any damage to the heart from acute rheumatic fever.  

Doctors and nurses at the hospital will treat any problems with the joints, skin, brain or heart, and give medicine to stop pain and fever.

Acute rheumatic fever usually goes away within a few weeks, with no damage to the joints, skin or brain.  

How does acute rheumatic fever affect the heart?

If the heart is affected during the acute rheumatic fever sickness, it may swell up. This swelling can cause damage to the small heart valves.

The heart valves open and close like doors to keep the blood moving through. If they are damaged they may be too loose or too tight, and they will not control the blood flow properly.

This damage to the heart valves is called rheumatic heart disease. 

The heart specialist at the hospital did an ultrasound of Michael’s heart. It showed some damage to the valves, and he said Michael had rheumatic heart disease. He explained that the damage to the heart valves was not too bad, but could get worse if Michael has acute rheumatic fever again.

The doctors and nurses explained that the best treatment to stop acute rheumatic fever coming back is penicillin needles every 21 to 28 days. 

Michael had his first penicillin needle in hospital, and when he came home he started to get the needles at our clinic. He did not like the needles at first, but he understands how important they are, and after a while they did not worry him at all.

Michael needs to have penicillin needles every 21 to 28 days until he is 21 years old.

Our family knows that it is important for Michael to get all his needles on time to keep his heart strong. We tell the clinic staff if we are going bush or travelling to town, and the Health Worker rearranges Michael's needles so that he does not miss any while we are away. 

Why are penicillin needles important?

Penicillin needles are given every 21 to 28 days to make sure there is always penicillin medicine in the body. If the strep germ is around, the penicillin will kill it so that it does not cause sore throats or skin sores, and so that there is no more acute rheumatic fever. Penicillin needles also stop the heart damage getting worse, and keep the heart strong.

If a needle is late, it should be given as soon as possible.

Regular penicillin needles should not be stopped until the heart specialist has checked the heart to make sure it is okay.

Penicillin is an antibiotic medicine that stops strep infections and stops acute rheumatic fever. Regular penicillin needles every 21 to 28 days are the best way to control acute rheumatic fever and rheumatic heart disease.

Michael has been seeing the doctor regularly and getting his penicillin needles on time. He has an ultrasound of his heart every year or so to make sure it is still strong. The heart specialist said Michael also needs to see the dentist every year, because a healthy mouth and teeth also help to keep the heart strong.

Michael has recently celebrated his 14th birthday. He is doing well at school, and he has not missed any footy games this season. The heart specialist said that if he has all his needles and looks after himself, he will still be able to stop the needles when he is 21 years old, and he should lead a normal healthy life.

I am very proud of Michael. He takes his health seriously because he wants to be a champion footy player one day.