How contagious is a rheumatic fever?

Rheumatic fever is not contagious. However, the often underlying infection of the upper respiratory tract with bacteria (streptococci) is contagious. These bacteria are transmitted from person to person by inhaling small droplets (droplet infection) or by close contact with affected persons (smear infection). To avoid infection, intensive hygiene measures (e.g. washing hands) or avoiding close contact with affected persons are recommended. Approximately 1 to 3% of those affected with a bacterial infection (streptococci) of the upper respiratory tract develop rheumatic fever.

Prognosis and complications

The prognosis is determined by the severity of the inflammation of the inner layer of the heart. If the patient recovers from rheumatic fever, the probability of a valvular heart defect occurring in the further course of the disease increases. Therefore, it is important to carry out early and consistent penicillin therapy as well as prophylactic penicillin administration prior to examinations and operations, before degenerative (= pathologically altered) and irreversible (=non-reversible) valve damage occurs.

Rheumatic fever of the heart

The leading symptoms of a rheumatic fever occur, among other things, in the heart. All structures of the human heart can be involved: the outer skin (“pericarditis“), the heart muscle tissue (“myocarditis“) and the inner skin (“endocarditis“). Depending on the inflamed area of the heart, different symptoms and consequential damage occur.

Dangerous is involvement of the inner wall of the heart, which can lead to heart valve defects. Frequently, it is mainly insufficient valves in the left heart as a result of endocarditis. If the heart muscle is involved, this can lead to the death of muscle cells, arrhythmia of the heart, formation of nodules and cardiac insufficiency.

If the pericardium is affected, this leads to chest pain. This inflammation can also be life-threatening if pericardial effusions occur. Typical is the audible pericardial rubbing during auscultation.

If cardiac involvement has occurred, especially with heart valve defects, drug prophylaxis must be continued for 5-10 years, in severe cases up to the age of 40. If treated, the acute inflammation of the heart heals within 4-8 weeks. Under certain circumstances, it can also take on chronic progressions.