Medicine: Red Plague

The biggest killer of children between the ages of five and 15 is rheumatic heart disease. In one year it claims almost twice as many victims as infantile paralysis does in ten. Today, about 1,000,000 people have been left crippled by this insidious, recurring malady.

Yet rheumatic heart disease, which smolders in slum districts and overcrowded tenements does not get a fraction of the publicity given to cancer or tuberculosis.

In the whole country there are only some 1,000 special sanatorium beds to tide victims over their long, hazardous convalescence. In most cities the disease is not reported to the board of health. And there is no central, coordinated plan of attack; the U.S. Public Health Service and the American Heart Association compile statistics, stimulate research, run good clinics, but cannot get the public interested.

To help stir doctors up about the “Red Plague,” Dr. Homer F. Swift of the Rockefeller Institute gave two speeches at Harvard last week at the annual New England Postgraduate Assembly. He showed pictures of rheumatic fever victims, gave doctors practical tips for treatment.

Sore Throat to Weak Heart. Rheumatic fever usually occurs after a streptococcal infection of the nose or throat. Warned Dr. Swift: “Watch tonsillitis! The average case requires up to six weeks of rest and medical care.” But, he added, “there is no evidence to show that removing infected tonsils removes the possibility of rheumatic fever.”

The disease is not caused directly by streptococci but seems to be an allergic response to their activity. After one attack, a patient is not immunized, but grows more susceptible. Afterwards, any slight streptococcal infection may bring on a new bout of fever.

Early symptoms are a tired feeling, loss of weight, rapid breathing, fast heart action, vague pains in the joints, commonly called “growing pains.” The child becomes pale, except for flushed cheekbones—the “rheumatic look.” He sometimes develops a typical rash, and his joints may become red, swollen, hot.

Then the disease usually attacks the heart muscles, lining, coat, or valves, often deforming them permanently, cutting down the power of the heart to withstand the strain of daily life.

Rest, Rest, Rest. During the fever, some drugs (salicylates) are useful. Chief thing to do: keep the child in bed. This may be for as long as a year. Nourishing food is necessary, and local treatment, such as hot compresses for swollen joints. Children with rheumatic hearts have to learn to walk, not run, to go upstairs one step at a time, play gentle games.