Rheumatic fever and rheumatic heart disease (RHD) remain one of the most silent yet preventable threats to children’s hearts in India. Despite advances in healthcare, myths and misconceptions continue to put young lives at risk. Current estimates suggest RHD affects 1.5–2 per 1,000 people across all ages, with a prevalence of 0.5-6 per 1,000 schoolchildren. More than 2 million Indians are currently living with this condition.
It all begins with something as common as an untreated throat infection caused by Group A Streptococcus. When the immune system overreacts, it doesn’t just attack the bacteria - it mistakenly damages the heart, joints, brain, and skin. Over time, this can leave permanent scars on the heart valves, leading to serious health issues.
Here are five myths that continue to endanger children and the truths parents must know.
1. “It’s just a sore throat — some syrup will do.”
A sore throat in a child is often dismissed, but it may be a strep infection. Inadequate or delayed treatment can trigger rheumatic fever and later heart problems. Over-the-counter syrups only mask symptoms and don’t eliminate bacteria.
Reality check: Every sore throat that persists or recurs should be checked by a paediatrician. Proper treatment at this stage prevents long-term harm.
2. “Rheumatic fever only affects rural or poor children.”
In contrast to the assumption that urban children are safe, the risk of rheumatic fever exists everywhere, including urban cities. The disease does not discriminate by income or address. Poor ventilation, apartments that are crowded and frequent infections make children in cities equally vulnerable.
Reality check: Take repeatedly sore throats seriously, ensure homes are sufficiently ventilated and well-lit, regardless of where you live.
3. “If my child feels better, I can stop antibiotics.”
This is one of the most harmful myths. Stopping an antibiotic treatment course partway through leaves bacteria behind, makes bacteria more resistant, and leads to recurring infections.
Reality check: It is extremely important to complete the prescribed antibiotic course. Feeling better does not mean the same as being cured. It's the antibiotics that are only half-finished that continue the cycle of disease.
4. “Rheumatic heart disease can spread from one child to another.”
There’s confusion between strep throat and RHD. While sore throat caused by Streptococcus is contagious, RHD is not. The damage occurs because of the body’s immune response, not from direct transmission.
Reality check: Focus on early treatment of throat infections rather than fearing that RHD itself can “spread.”
5. “My child is too young for heart trouble — why put them through painful injections?”
Penicillin injections, given every 3–4 weeks for up to 10 years, are the backbone of RHD prevention. Though uncomfortable, they stop recurrence and protect heart valves.
Reality check: Secondary prophylaxis is life-saving. Skipping injections today could mean valve surgery tomorrow. Parents must ensure their children are consistent with their treatment as it protects their child’s long-term health.
Moving Forward: Prevention Is the Best Cure
Rheumatic fever can be prevented entirely, if treated early. This involves two most important steps: timely care for strep throat and long-term prophylaxis for diagnosed cases. Across urban and rural India, awareness campaigns, wider access to rapid strep tests and stronger can make a difference.
Every parent who chooses to treat a sore throat seriously is taking a powerful step toward preventing heart disease in the next generation.
(Dr. Shivangi Bora, Consultant Paediatrician at BabyMD)
It all begins with something as common as an untreated throat infection caused by Group A Streptococcus. When the immune system overreacts, it doesn’t just attack the bacteria - it mistakenly damages the heart, joints, brain, and skin. Over time, this can leave permanent scars on the heart valves, leading to serious health issues.
Here are five myths that continue to endanger children and the truths parents must know.
1. “It’s just a sore throat — some syrup will do.”
A sore throat in a child is often dismissed, but it may be a strep infection. Inadequate or delayed treatment can trigger rheumatic fever and later heart problems. Over-the-counter syrups only mask symptoms and don’t eliminate bacteria.
Reality check: Every sore throat that persists or recurs should be checked by a paediatrician. Proper treatment at this stage prevents long-term harm.
2. “Rheumatic fever only affects rural or poor children.”
In contrast to the assumption that urban children are safe, the risk of rheumatic fever exists everywhere, including urban cities. The disease does not discriminate by income or address. Poor ventilation, apartments that are crowded and frequent infections make children in cities equally vulnerable.
Reality check: Take repeatedly sore throats seriously, ensure homes are sufficiently ventilated and well-lit, regardless of where you live.
3. “If my child feels better, I can stop antibiotics.”
This is one of the most harmful myths. Stopping an antibiotic treatment course partway through leaves bacteria behind, makes bacteria more resistant, and leads to recurring infections.
Reality check: It is extremely important to complete the prescribed antibiotic course. Feeling better does not mean the same as being cured. It's the antibiotics that are only half-finished that continue the cycle of disease.
4. “Rheumatic heart disease can spread from one child to another.”
There’s confusion between strep throat and RHD. While sore throat caused by Streptococcus is contagious, RHD is not. The damage occurs because of the body’s immune response, not from direct transmission.
Reality check: Focus on early treatment of throat infections rather than fearing that RHD itself can “spread.”
5. “My child is too young for heart trouble — why put them through painful injections?”
Penicillin injections, given every 3–4 weeks for up to 10 years, are the backbone of RHD prevention. Though uncomfortable, they stop recurrence and protect heart valves.
Reality check: Secondary prophylaxis is life-saving. Skipping injections today could mean valve surgery tomorrow. Parents must ensure their children are consistent with their treatment as it protects their child’s long-term health.
Moving Forward: Prevention Is the Best Cure
Rheumatic fever can be prevented entirely, if treated early. This involves two most important steps: timely care for strep throat and long-term prophylaxis for diagnosed cases. Across urban and rural India, awareness campaigns, wider access to rapid strep tests and stronger can make a difference.
Every parent who chooses to treat a sore throat seriously is taking a powerful step toward preventing heart disease in the next generation.
(Dr. Shivangi Bora, Consultant Paediatrician at BabyMD)
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