Abstract
The incidence of in-hospital cases of acute rheumatic fever in residents of the San Fernando Valley section of Los Angeles (population 1,096,000) from 1971 through 1980 was 0.21 per 100,000 population for all ages and 0.63 per 100,000 for 5 to 17 year olds, both among the lowest ever reported in the world literature. Nevertheless, minority group patients had five times the risk of a white patient for acute rheumatic fever developing and a greater than 20-fold increase in the risk for the development of acute rheumatic fever with carditis. Unexpectedly, a low 30% of cases (8/27) had carditis either alone or with other major criteria, while a high 59% (16/27) had polyarthritis as the only major manifestation. This suggests the possibility of false-positive cases based on polyarthritis as the only major manifestation, and that an incidence of acute rheumatic fever may have been reached that is so low that “background” cases are a significant proportion of all cases.
Full text
PDF





Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allen W. C. Rheumatic fever and rheumatic heart disease in Missouri. Mo Med. 1982 Apr;79(4):219–224. [PubMed] [Google Scholar]
- Annegers J. F., Pillman N. L., Weidman W. H., Kurland L. T. Rheumatic fever in Rochester, Minnesota, 1935-1978. Mayo Clin Proc. 1982 Dec;57(12):753–757. [PubMed] [Google Scholar]
- BRINK W. R., RAMMELKAMP C. H., Jr, DENNY F. W., WANNAMAKER L. W. Effect in penicillin and aureomycin on the natural course of streptococcal tonsillitis and pharyngitis. Am J Med. 1951 Mar;10(3):300–308. doi: 10.1016/0002-9343(51)90274-4. [DOI] [PubMed] [Google Scholar]
- Brownell K. D., Bailen-Rose F. Acute rheumatic fever in children. Incidence in a borough of New York City. JAMA. 1973 Jun 18;224(12):1593–1597. [PubMed] [Google Scholar]
- Chun L. T., Reddy V., Rhoads G. G. Occurrence and prevention of rheumatic fever among ethnic groups of Hawaii. Am J Dis Child. 1984 May;138(5):476–478. doi: 10.1001/archpedi.1984.02140430052013. [DOI] [PubMed] [Google Scholar]
- Coulehan J., Grant S., Reisinger K., Killian P., Rogers K. D., Kaltenbach C. Acute rheumatic fever and rheumatic heart disease on the Navajo reservation, 1962-77. Public Health Rep. 1980 Jan-Feb;95(1):62–68. [PMC free article] [PubMed] [Google Scholar]
- DENNY F. W., WANNAMAKER L. W., HAHN E. O. Comparative effects of penicillin, aureomycin and terramycin on streptococcal tonsillitis and pharyngitis. Pediatrics. 1953 Jan;11(1):7–13. [PubMed] [Google Scholar]
- DiSciascio G., Taranta A. Rheumatic fever in children. Am Heart J. 1980 May;99(5):635–658. doi: 10.1016/0002-8703(80)90739-5. [DOI] [PubMed] [Google Scholar]
- Ekelund H., Enocksson E., Michaëlsson M., Voss H. The incidence of acute rheumatic fever in Swedish children 1952-1961. A survey from four hospitals. Acta Med Scand. 1967 Jan;181(1):89–92. doi: 10.1111/j.0954-6820.1967.tb07231.x. [DOI] [PubMed] [Google Scholar]
- FEINSTEIN A. R., WOOD H. F., SPAGNUOLO M., TARANTA A., JONAS S., KLEINBERG E., TURSKY E. RHEUMATIC FEVER IN CHILDREN AND ADOLESCENTS. A LONG-TERM EPIDEMIOLOGIC STUDY OF SUBSEQUENT PROPHYLAXIS, STREPTOCOCCAL INFECTIONS, AND CLINICAL SEQUELAE. VII. CARDIAC CHANGES AND SEQUELAE. Ann Intern Med. 1964 Feb;60:SUPPL 5–6123. [PubMed] [Google Scholar]
- Gordis L., Lilienfeld A., Rodriguez R. Studies in the epidemiology and preventability of rheumatic fever. I. Demographic factors and the incidence of acute attacks. J Chronic Dis. 1969 Feb;21(9):645–654. doi: 10.1016/0021-9681(69)90036-8. [DOI] [PubMed] [Google Scholar]
- Holmberg S. D., Faich G. A. Streptococcal pharyngitis and acute rheumatic fever in Rhode Island. JAMA. 1983 Nov 4;250(17):2307–2312. [PubMed] [Google Scholar]
- Krober M. S., Bass J. W., Michels G. N. Streptococcal pharyngitis. Placebo-controlled double-blind evaluation of clinical response to penicillin therapy. JAMA. 1985 Mar 1;253(9):1271–1274. doi: 10.1001/jama.253.9.1271. [DOI] [PubMed] [Google Scholar]
- Land M. A., Bisno A. L. Acute rheumatic fever. A vanishing disease in suburbia. JAMA. 1983 Feb 18;249(7):895–898. [PubMed] [Google Scholar]
- Merenstein J. H., Rogers K. D. Streptococcal pharyngitis. Early treatment and management by nurse practitioners. JAMA. 1974 Mar 18;227(11):1278–1282. doi: 10.1001/jama.227.11.1278. [DOI] [PubMed] [Google Scholar]
- Nelson J. D. The effect of penicillin therapy on the symptoms and signs of streptococcal pharyngitis. Pediatr Infect Dis. 1984 Jan-Feb;3(1):10–13. doi: 10.1097/00006454-198401000-00004. [DOI] [PubMed] [Google Scholar]
- Powell K. E., Watson D. G. Acute rheumatic fever in Mississippi: a survey of hospitalized cases, 1964 to 1973. South Med J. 1981 May;74(5):553–557. doi: 10.1097/00007611-198105000-00013. [DOI] [PubMed] [Google Scholar]
- Quinn R. W., Federspiel C. F. The incidence of rheumatic fever in metropolitan Nashville, 1963-1969. Am J Epidemiol. 1974 Apr;99(4):273–280. doi: 10.1093/oxfordjournals.aje.a121612. [DOI] [PubMed] [Google Scholar]
- Rhodes P., Jackson H. Rheumatic fever in Colorado. A conquered disease? JAMA. 1975 Oct 13;234(2):157–158. [PubMed] [Google Scholar]
- Schwartz R. H., Hepner S. I., Ziai M. Incidence of acute rheumatic fever. A suburban community hospital experience during the 1970s. Clin Pediatr (Phila) 1983 Dec;22(12):798–801. doi: 10.1177/000992288302201202. [DOI] [PubMed] [Google Scholar]
- Silberg S. L., Ferguson S. W., Anderson P. S., Jr Incidence of rheumatic fever and rheumatic heart disease in Oklahoma. J Okla State Med Assoc. 1971 Dec;64(12):477–481. [PubMed] [Google Scholar]
- Tamer D. M. Acute rheumatic fever in a South Florida county hospital, 1967-1971. Circulation. 1974 Oct;50(4):765–767. doi: 10.1161/01.cir.50.4.765. [DOI] [PubMed] [Google Scholar]
- Tolaymat A., Goudarzi T., Soler G. P., Miller R. H., Ayoub E. M. Acute rheumatic fever in north Florida. South Med J. 1984 Jul;77(7):819–823. doi: 10.1097/00007611-198407000-00007. [DOI] [PubMed] [Google Scholar]

