Rheumatic fever still a threat in SA, says foundation

The Heart and Stroke Foundation South Africa (HSFSA) is observing Rheumatic Fever Week from today, Friday August 1 to Thursday, August 7, raising awareness about the serious consequences of untreated strep throat infections.

According to the HSFSA, failing to treat strep throat can lead to rheumatic fever (RF) and ultimately rheumatic heart disease (RHD) - a potentially fatal condition that causes permanent damage to the heart valves.

While RHD has largely been eliminated in high-income countries, it continues to pose a serious health burden in South Africa and other low- and middle-income nations.

HSFSA CEO, Professor Pamela Naidoo, stressed the importance of early treatment. “Antibiotics such as penicillin can prevent rheumatic fever if strep throat is treated promptly,” she said. “RHD is often linked to poverty and overcrowding, and poor access to healthcare makes the situation worse.”

A 2025 surveillance report from the National Institute for Communicable Diseases (NICD) revealed an average of 824 Group A Streptococcus infections a year between 2021 and 2024, although the actual figures are likely higher due to underreporting.

Globally, the World Health Organisation (WHO) estimates that 55 million people live with RHD, with 360,000 deaths recorded in 2021. Children aged 5 to 14 are most at risk of initial infection, while the disease is most prevalent in adults aged 20 to 39.

Professor Naidoo said advanced RHD may require lifelong treatment, regular monitoring, and in some cases, heart valve surgery – procedures not always accessible in under-resourced healthcare systems.

A statement sent from HSFSA said that evidence from South African hospitals, such as Chris Hani Baragwanath, shows that early medical intervention improves survival rates.

Gerhard De Koe, CEO of the Namibia’s Heart Foundation said the HSFSA urges parents and caregivers to take high fevers seriously and seek immediate medical attention for sore throats in children. 

“We need to stop throat infections in their tracks,” he said.

Rheumatic Fever Week aims to increase public awareness and reduce the incidence of RHD through education and improved access to care.

For more information visit www.heartfoundation.co.za