Related Experiment Videos

Continued high caseload of rheumatic fever in western Pennsylvania: Possible rheumatogenic emm types of streptococcus

Judith Marie Martin1, Karen A Barbadora

  • 1Department of Pediatrics, Division of Allergy, Immunology and Infectious Diseases, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

The Journal of Pediatrics
|July 25, 2006
PubMed
Abstract

Insights

Acute rheumatic fever (ARF) continues to be a concern in western Pennsylvania, with 121 cases identified between 1994 and 2003. Molecular typing identified specific group A Streptococcus (GAS) strains, including emm type 12, potentially linked to ARF.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Epidemiology

Background:

  • Acute rheumatic fever (ARF) incidence has declined nationally.
  • Understanding regional ARF occurrence is crucial for public health.
  • Western Pennsylvania's ARF rates needed evaluation.

Purpose of the Study:

  • To determine the incidence of ARF cases in western Pennsylvania from 1994 to 2003.
  • To identify circulating group A Streptococcus (GAS) strains associated with ARF.
  • To investigate potential rheumatogenic GAS strains.

Main Methods:

  • Retrospective review of 121 ARF cases at Children's Hospital of Pittsburgh (1994-2003).
  • Throat cultures for GAS performed on patients and family members.
  • Molecular typing (FIGE and emm typing) of GAS isolates.

Main Results:

  • 121 ARF cases were identified; 57% were male, median age 10 years.
  • Carditis was the most common manifestation (57%).
  • GAS was detected in 36% of ARF patients and 14% of family members; emm type 12 was noted as potentially rheumatogenic.

Conclusions:

  • ARF remains a significant public health issue in western Pennsylvania.
  • Identifying specific emm types associated with ARF is important.
  • This data can inform future vaccine development for ARF.

Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Streptococcal Pharyngitis01:27

Streptococcal Pharyngitis

Streptococcal pharyngitis, commonly known as “strep throat,” is an acute infection of the oropharyngeal tissues caused by the Gram‑positive Group A Streptococcus (Streptococcus pyogenes). Transmission occurs primarily through respiratory droplets expelled during coughing, sneezing, or talking.Mechanisms of Host Entry and Immune EvasionUpon entering the host, S. pyogenes adheres to the mucosal epithelial cells of the pharynx via surface proteins, notably lipoteichoic acid and the antiphagocytic...
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
Rocky Mountain Spotted Fever01:26

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.