Pioneers and modern ideas. Rheumatic fever--a half-century perspective.
1998; National Institutes of Health; Volume: 102; Issue: 1 Pt 3 Linguagem: Inglês
Autores Tópico(s)
Streptococcal Infections and Treatments
ResumoThere have been striking changes in the incidence of rheumatic fever in the United States over the past 50 years. Rheumatic fever was a serious health problem for young people during the 1930s and 1940s. This may be appreciated best by briefly sharing with you my own experience in 1946 when I worked for a year in a rheumatic fever convalescent hospital on the outskirts of New York City. The hospital was filled with 90 children and adolescents, and there was even a waiting list. Almost all of the patients had heart disease and were convalescing from 6 months to 1 year after one or more attacks of acute rheumatic fever. This experience had a deep and lasting impression on me, and nurtured my interest in this disease over the last half century. There were a number of such convalescent hospitals near cities with large urban populations. For example, the House of Good Samaritan here in Boston cared for >2000 rheumatic fever patients between 1921 and 1970. My associate, Dr Leon Gordis, conducted a study on the incidence of rheumatic fever in Baltimore City between 1960 and 1964. He found an incidence of 24 per 100 000—only a modest decline from earlier figures. He identified 261 patients with an attack of rheumatic fever during a 5-year period in the early 1960s. The majority of these patients lived in inner-city Baltimore. At that time, and for decades before that, rheumatic fever had almost always been concentrated in urban populations living in poor, crowded neighborhoods. Dr Gordis repeated the rheumatic fever incidence survey in Baltimore for the years 1977 to 1981 and found a striking decline to 0.5 per 100 000 population, a remarkable 50-fold drop.1Incidence figures reported from other parts of the country were almost equally as low. The virtual disappearance …
Referência(s)