Incidence of rheumatic fever and prevalence of rheumatic heart disease in India.

Rheumatic heart disease (RHD) has been documented in Indian medical literature since the early nineteenth century, contrary to the popular belief that rheumatic fever (RF) and its sequelae were exclusively prevalent in temperate climates until the early twentieth century. Rheumatic heart disease has, in the past 50 years, emerged as a major contributor to cardiovascular morbidity in India. Despite the paucity of clear information regarding secular trends, the few available community surveys indicate that there are at present more than 1 million patients with RHD. Even a conservative estimate of the incidence of RF suggests that at least 50,000 new episodes occur every year. The younger age of onset (juvenile RHD) seen in India is a special feature of both public health and clinical importance. These patterns of RF and RHD, which may be similar to those in other developing countries, underscore the importance of effective public health strategies for prevention and control.