Rheumatic fever and rheumatic heart disease : report of a WHO study group [meeting held in Geneva from 30 March to 4 April 1987]

Abstract

A review of the current state of knowledge and medical and public health practice with regard to group A streptococcal infections, rheumatic fever, and rheumatic heart disease and the advances that have occurred over the past twenty years. Recommendations are made for improving implementation of rheumatic fever control programmes, and on areas where specific basic and applied research is needed to control this problem more effectively. Of particular practical value is a section devoted to prevention, which offers detailed guidance on recommended antibiotic regimens for primary and secondary prophylaxis, including recommended drug, mode of administration, dose, and duration of treatment. Prospects for the development of a suitable vaccine are also briefly considered. Other sections discuss the requirements for prevention programmes at the community level, outline methods for diagnosis in the microbiology laboratory, and present recommended clinical procedures for diagnosis and management. In view of the importance of preventing infective endocarditis in patients with rheumatic valvular heart disease, the book also recommends treatment schedules for prophylaxis during dental, respiratory, gastrointestinal and genitourinary tract procedures