Prevention of rheumatic fever and its relapse The following prevent rheumatism: primary and secondary. Primary prevention of rheumatic fever is a set of certain measures aimed at minimizing the incidence of streptococcal infection, and when it occurs it is timely and properly treated. Secondary prevention of rheumatic fever is a complex of certain measures aimed at preventing recurrences and progression of the disease in people who have already undergone a rheumatic attack.


Primary prevention of rheumatism

Primary prophylaxis implies the organization of a healthy life: ventilation of premises( working and residential), walking outdoors, tempering the body, full, regular, balanced nutrition. It is also possible to include timely isolation of a streptococcal infection and subsequent follow-up of people in contact with it( for at least seven days).

In case of epidemic of streptococcal infection in any group( boarding school, military unit, kindergarten, sanatorium. ..) or simultaneous detection of several cases of acute rheumatism, it is necessary not only to isolate patients, but also to bicillin prophylaxis of all persons in contact with them. Immediately intramuscularly administered bicillin-5( preschool - 750 thousand units, children of school age and older - 1500 thousand units) or bicillin-1( pre-school - 600 thousand units, children of school age and older - 1200 thousand units).



Primary prevention is also attributed to timely and correct sanitation of foci of chronic infection, especially in the nasopharynx( sinusitis, tonsillitis, sinusitis, pharyngitis).Important is the sanation of the nasopharynx in children, adolescents and youth, often suffering from exacerbations of nasopharyngeal infection and in whose family there were or are rheumatic patients. The sanation of foci of infection should be radical, but the methods of treatment are determined only by specialist doctors.

It is important that the treatment of streptococcal infection is correct and on time started. Treatment, which entered into force no later than the third day from the onset of streptococcal infection, rheumatism is excluded almost completely. Treatment of acute streptococcal infections is carried out with antibiotics for ten days;Most often prescribed penicillin at a dosage of 100-300 thousand units per kilogram of body weight per day or erythromycin - children 30 mg per kilogram of body weight per day, adults -150-200 thousand units per day. At the same time, it is recommended to take anti-inflammatory drugs: acetylsalicylic acid, methindole, brufen for seven to ten days.

After a streptococcal infection, the patient should be thoroughly diagnosed: urine and blood and urine tests should be done, and only at normal rates can the patient be sent to the extract. After suffering angina for two to three months, the patient needs to be monitored by a pediatrician, a therapist, a rheumatologist.

Responsibility for primary prevention is borne not only by medical workers, because it is not just about the organization of everyday life and proper nutrition. Everyone should pay attention to their own health and, if necessary, go to the hospital in time.

Secondary prophylaxis of rheumatism

Because rheumatic fever is prone to a recurring course, prevention involves long, long-term interventions. The main role is assigned to dispensary observation, performed by a rheumatologist of a polyclinic or specialized rheumatological centers.

Directions of secondary prevention :

  • increase in body resistance: therapeutic physical training, general wellness, hardening, proper nutrition, etc.;
  • bicillin prophylaxis, which is aimed at the destruction of streptococcal infection;
  • long-term antirheumatic therapy with non-steroidal anti-inflammatory drugs;
  • sanation of chronic infectious foci.

Bicillin prophylaxis is the key link in the prevention of rheumatism in our country since 1958.

Prophylactic administration of biciliary is indicated for all patients who have suffered a rheumatic process, even if there is heart failure.

Patients who have undergone polyarthritis, primary acute or subacute rheumatic heart disease without signs of valvular heart disease, carry out year-round bicillin-medication prophylaxis lasting three years. After carrying the chorea with a protracted course, the primary rheumatic heart disease with the defeat of the heart valves, as well as all patients with recurrent rheumatic carditis and foci of chronic infection, prevention is carried out for five years already.

Bicillin-5 is administered intramuscularly to preschool children - 750 thousand units once every two weeks, children of school age and older - at a dose of 1500 thousand units once every four weeks. Bicillin-1 is administered intramuscularly at a dose of 1200 thousand units once every three to four weeks. In addition to regular injections of bicillin twice a year( i.e., in the spring and in the autumn), aspirin is prescribed for four to six weeks( adults - 2 g per day, children - 0.14 g for one year of life, but not more than one gram per day) orOther antirheumatic drugs, such as: ibuprofen, indomethacin, etc. In the spring and winter, drug prevention is combined with the intake of vitamins, including with ascorbic acid( vitamin C).

If bicillin prophylaxis is not effective, and a person still develops pharyngitis, angina, etc., then they prescribe a ten-day treatment with antibiotics and anti-inflammatory drugs - this is the current prevention of rheumatism.

Surgical intervention in a patient with rheumatism( abortion, tonsils, tooth extraction, etc.) is performed in combination with penicillin.

Bicillin-5 is prescribed for suffering rheumatism during pregnancy from the age of eight to ten weeks and up to delivery. After giving birth, the duration of bicillin prophylaxis is determined by the activity of the rheumatic process.

Be Healthy!