Tofiga Fepulea'i: Talofa lava. My name is Tofiga and I’m here to talk to you about rheumatic fever. Show I want you to know all about it. How it works and how you can avoid it, so that it doesn’t affect your children or your whānau. [Video of Tofiga Fepulea’i standing in school grounds, talking to camera] What is rheumatic fever? [Title slide with text of heading; music track; no voiceover] Tofiga Fepulea'i: Rheumatic fever is a serious disease that can affect your child’s heart. You can’t catch rheumatic fever. But you can catch the strep throat germs that can sometimes turn into rheumatic fever. Sounds tricky? Let’s talk to someone who knows a whole lot more than I do. [Video of Tofiga Fepulea’i standing within school grounds, talking to camera] Dr Sarah Sciascia: Kia ora, my name is Doctor Sarah Sciascia. I’m a GP at Ora Toa Takapuwahia Medical Centre in Porirua. Sore throats are common in children. Usually, a sore throat can be caused by a common cold or a flu and get better on its own. [Video of Dr Sciascia in her clinic, talking to camera] But strep throat is different. It needs to be treated with antibiotics straight away. Rheumatic fever can develop from a strep throat if it’s not treated with antibiotics. [Dr Sciascia voiceover. Video of children and mum heading towards the clinic in slow motion and being welcomed in by the nurse – children sit on the clinic bed] Sometimes it can be hard to tell the difference [Video close up of Dr Sciascia talking to camera] between a common sore throat and a strep throat by just looking at it, [Video cuts to close up of nurse’s hands as she puts on rubber gloves] so get your child’s sore throat checked by a doctor or a nurse. [Video close up of child getting a throat swab] They may take a throat swab to test for the strep germs. [Video close up of Dr Sciascia talking to camera] How does strep throat turn into Rheumatic Fever? [Title slide with text of heading; music track; no voiceover] Dr Sarah Sciascia: In some young people – mostly aged between 4 and 19 – if a strep throat is not treated with antibiotics it can turn into rheumatic fever. This usually happens 1 to 5 weeks after your child has had a strep throat. [Video of Dr Sciascia in the clinic talking to camera] Dr Sarah Sciascia voiceover: What happens is, sometimes when the child’s body tries to kill the strep throat germs mistakenly it attacks other parts of the body too. So the young person can have sore joints like their ankles, their knees and their hips. They can feel really tired. And these are signs of rheumatic fever. It can sometimes go on to cause damage to the heart valves, which can lead to rheumatic heart disease – the next stage after rheumatic fever. [Video shows animated diagram of strep throat germs going into the mouth and throat, then pulls back to show the full body with joints highlighted by red pulsing circles and a pulsing, damaged heart – the areas most affected by rheumatic fever and rheumatic heart disease] Dr Sarah Sciascia: People with rheumatic heart disease may need heart surgery. Because of damage to the heart, rheumatic heart disease can sometimes lead to an early death. [Video of Dr Sciascia in clinic, talking to camera] How rheumatic fever affects your child and your whānāu [Title slide with text of heading; music track; no voiceover] Tofiga Fepulea'i: My family has been affected by rheumatic fever – my aunty got it when she was just a young girl. And I hear stories. Powerful stories. Like a young woman from this very community. [Video close up of Tofiga Fepulea’i talking to camera] Tofiga Fepulea'i voiceover: She’s 17 now, but when she was 9 she found out she had rheumatic fever. Her joints were sore, she was really, really tired every day, [Video cuts to close up of Tofiga and the young woman’s feet as they walk along the beach] her feet got so sore she couldn’t even walk. When she was told she went straight to the hospital and spent 8 months in bed. No playing, no out and about, you know it was a scary, hard time for the whole family. When she was 10, things got a whole lot worse. The doctors said that she needed a heart valve transplant and she was flown straight to Starship hospital in Auckland. [Video shots of Tofiga Fepulea’i walking along the beach with the young woman who shared her story] Tofiga Fepulea'i: Since then she has had Penicillin injections once a month – and she still has a few years of this to go. She tells everyone, if your children have sore throats please get them checked. [Video of Tofiga Fepulea’i in school grounds talking to camera] Rheumatic fever is preventable [Title slide with text heading; music track; no voiceover] Dr Sarah Sciascia: Rheumatic fever is preventable. If your child is given antibiotics for a strep throat, they need to take them for the whole 10 days – even if they’re feeling better. It takes 10 days to kill all the strep throat germs. Tofiga Fepulea'i: Children can get strep throat more than once. Every time your child has a sore throat, please get it checked out, and if it is strep throat again, they will need antibiotics again. And just like a cold or a flu, strep throat germs can be easily spread. So remember when coughing and sneezing cover your mouth and wash and dry your hands often, especially after coughing and sneezing. [Video of Dr Sciascia and Tofiga Fepulea’i in the clinic. As doctor instructs to ‘cover your mouth’, ‘wash and dry hands’, Tofiga mimes the actions, then coughs into his elbow. He jokingly wipes the germs from his arm and sprinkles them over the doctor who reacts with a mock tap at Tofiga] Text only: Tena Koe, Fa’afetai, Malo Thank you for your support and help in developing this video.
[Video text frame of acknowledgements – music track; no voiceover] For more information about preventing rheumatic fever visit rheumaticfever.health.govt.nz [Video endframe with url to visit, programme logo (Stop Sore Throats Hurting Hearts) and organisational logos (Ministry of Health and Health Promotional Agency) – music track; no voiceover] What are symptoms of rheumatic fever in children?Common symptoms can include: Inflammation in joints such as the knees or ankles that causes swelling, soreness, and redness. Small, painless, hard bumps (nodules) under the skin, often over bony areas. Unusual jerky movements, most often of the face and hands.
What is the sign and symptoms of rheumatic fever?Symptoms of rheumatic fever
redness, pain and swelling of your joints (arthritis), usually ankles, knees, wrists or elbows. pain in your chest, breathlessness and a fast heart rate. jerky, uncontrollable movements in your hands, feet and face. tiny bumps under your skin.
When assessing a child for signs and symptoms of rheumatic fever which symptoms should the nurse anticipate?Your child's healthcare provider will look for:. Inflammation of the heart.. Inflammation of more than one joint.. Unusual jerky movements.. Small, hard bumps under the skin.. Red, irregular rash.. Fever.. Pain in one or more joints.. Previous inflammation of the heart.. What is the commonest clinical feature in children with rheumatic?Polyarthritis is the most common symptom and is frequently the earliest manifestation of acute rheumatic fever (70-75%). Characteristically, the arthritis begins in the large joints of the lower extremities (ie, knees, ankles) and migrates to other large joints in the lower or upper extremities (ie, elbows, wrists).
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Which signs and symptoms would the nurse expect to assess in a child with rheumatic fever?
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