Rheumatic Fever in Grand Rapids, MI

Rheumatic fever is an inflammatory disease that can develop after an untreated infection with Group A Streptococcus (strep), most commonly “strep throat.” It can affect the heart, joints, skin, and brain. Rheumatic fever is considered an autoimmune condition because the body’s immune response to the bacteria mistakenly attacks its own tissues.

In Grand Rapids and across West Michigan, timely diagnosis and treatment of strep throat are essential to prevent rheumatic fever and its serious complication, rheumatic heart disease.

Who Is at Risk in Grand Rapids?

Rheumatic fever can occur at any age, but it most commonly affects children between 5 and 14 years old.

While rheumatic fever is now rare in the United States, certain factors can increase risk, including:

  • Recent untreated or partially treated strep throat or scarlet fever
  • Crowded living conditions (multi-family housing, shelters, dormitories)
  • Limited access to regular medical or dental care
  • Household members with frequent strep infections

In Grand Rapids, families without consistent primary care, or those who delay care during the winter respiratory season, may face higher risk. Cold Michigan winters mean more time indoors, where strep and other respiratory infections spread more easily in schools, daycare centers, and workplaces.

How Rheumatic Fever Develops

Rheumatic fever usually appears 2–4 weeks after a strep throat infection that was:

  • Not treated
  • Treated late
  • Treated with an incomplete course of antibiotics

The immune system creates antibodies to fight the strep bacteria. In some people, these antibodies also react with the body’s own tissues, especially:

  • Heart (carditis)
  • Joints (arthritis)
  • Skin
  • Brain and nervous system

Only a small percentage of people with strep throat will develop rheumatic fever, but because the consequences can be serious, all suspected strep throat in children and teens in Grand Rapids should be evaluated and treated promptly.

Symptoms of Rheumatic Fever

General (Systemic) Symptoms

  • Sudden onset of fever
  • Fatigue and low energy
  • Unexplained weight loss (less common, but may occur)

Joint Symptoms

  • Painful, swollen, warm joints (arthritis), often:
    • Moving from one joint to another (migratory)
    • Commonly affecting knees, ankles, elbows, and wrists

Heart Symptoms (Carditis)

Inflammation of the heart can cause:

  • Chest pain
  • Shortness of breath (breathlessness), especially with activity or when lying down
  • Rapid heartbeat (tachycardia), even at rest
  • Heart murmur (heard by a healthcare provider with a stethoscope)

Carditis can lead to rheumatic heart disease, which may permanently damage heart valves.

Skin and Nervous System Symptoms

  • Skin changes

    • Faint, raised, ring-shaped rash (erythema marginatum), usually on the trunk or limbs
    • Small, painless lumps under the skin (subcutaneous nodules), often near affected joints

  • Nervous system problems

    • Involuntary movements or twitches, especially of the face, hands, or feet
    • This is called Sydenham’s chorea (also known as Saint Vitus’ dance)
    • May be accompanied by emotional changes, such as irritability or mood swings

Most symptoms improve with proper medical treatment, but heart damage can be long-lasting if not addressed early.

Rheumatic Heart Disease

How It Develops

Rheumatic heart disease is long-term damage to the heart valves caused by rheumatic fever. It can result from:

  • Repeated or prolonged episodes of rheumatic fever in childhood
  • Occasionally, a single severe episode of rheumatic fever

Inflammation can damage:

  • Heart muscle
  • Heart lining
  • Heart valves (most commonly the mitral and aortic valves)

Symptoms of Rheumatic Heart Disease

Some people have no symptoms for years. When symptoms do occur, they may include:

  • Shortness of breath, especially with activity
  • Chest pain or discomfort
  • Heart palpitations (feeling like the heart is racing, pounding, or skipping beats)
  • Swelling in the legs, ankles, or feet
  • Fatigue and reduced exercise tolerance

In severe cases, rheumatic heart disease can lead to heart failure, stroke, or the need for valve surgery.

If you or your child in Grand Rapids has a history of rheumatic fever, regular follow-up with a cardiologist at local centers such as Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, Metro Health – University of Michigan Health, or Mercy Health is important.

Risk Factors Relevant to Grand Rapids and West Michigan

Certain living and social conditions can increase the risk of strep infections and, therefore, rheumatic fever:

  • Poverty and overcrowding

    • Multiple families or many people living in small spaces
    • Limited ability to isolate when someone is sick

  • Limited access to medical care

    • No established primary care provider or pediatrician
    • Transportation barriers to clinics or urgent care
    • Lack of insurance or fear of cost, causing delayed care

  • Frequent skin infections or untreated wounds

    • Strep can sometimes enter through cuts, scrapes, or skin infections

In Kent County, community health resources such as the Kent County Health Department and Grand Rapids Public Health programs can help connect families to clinics, vaccinations, and low-cost or sliding-scale care.

How Rheumatic Fever Is Diagnosed

There is no single test that confirms rheumatic fever. Diagnosis is based on:

Medical History

  • Recent strep throat or scarlet fever
  • Symptoms such as fever, joint pain, rash, or unusual movements

Physical Examination

  • Checking joints for swelling and tenderness
  • Listening to the heart for murmurs or signs of inflammation
  • Looking for skin rash or nodules
  • Observing for involuntary movements

Laboratory and Imaging Tests

Healthcare providers in Grand Rapids may order:

  • Throat swab to test for Group A Streptococcus (may be negative if the infection has already resolved)

  • Blood tests to:

    • Look for antibodies indicating recent strep infection (e.g., ASO titer)
    • Check for markers of inflammation (ESR, CRP)

  • Electrocardiogram (ECG)

    • Measures the electrical activity of the heart
    • Can show rhythm changes or heart inflammation

  • Chest X-ray

    • Looks for heart enlargement
    • Checks the lungs for congestion or fluid

  • Echocardiogram (heart ultrasound)

    • Often done at hospitals like Corewell Health or Trinity Health Grand Rapids
    • Evaluates heart valve structure and function
    • Detects rheumatic heart disease early

Treatment of Rheumatic Fever in Grand Rapids

Treatment aims to:

  1. Eliminate any remaining strep bacteria
  2. Reduce inflammation and relieve symptoms
  3. Protect the heart and prevent future episodes

Hospital Care

Many patients, especially children, are admitted to the hospital (e.g., Corewell Health Helen DeVos Children’s Hospital) for:

  • Close monitoring of heart function
  • Pain and fever control
  • Evaluation by cardiology or infectious disease specialists if needed

Antibiotic Treatment

  • Penicillin is the standard treatment, usually given:

    • As an intramuscular injection
    • Or as an oral course, depending on the situation

  • After the initial treatment, long-term antibiotic prophylaxis is often required to prevent new strep infections and protect the heart:

    • Monthly penicillin injections, or
    • Daily oral antibiotics
    • Duration may be 5 years or longer, or until early adulthood, depending on heart involvement

Anti-inflammatory Medications

  • Aspirin or other anti-inflammatory medicines are used to:

    • Reduce joint pain and swelling
    • Lower fever

  • Corticosteroids (such as prednisone) may be used if:

    • Arthritis is severe
    • There is significant heart inflammation (carditis)

Treatment of Rheumatic Heart Disease

If heart valves are damaged:

  • Ongoing follow-up with a cardiologist

  • Medications to:

    • Control symptoms
    • Manage heart rhythm
    • Reduce fluid buildup

  • In some cases, cardiac catheter procedures or heart valve surgery may be needed. These services are available through major Grand Rapids health systems like Corewell Health and Trinity Health Grand Rapids.

Long-Term Outlook

With prompt diagnosis and proper treatment, the long-term outlook for people with rheumatic fever is generally excellent.

However:

  • Having rheumatic fever once does not provide immunity. You can get it again if you have another untreated strep infection.
  • It is essential to seek immediate medical care for any future sore throats, especially in children and teens who have had rheumatic fever.
  • Long-term antibiotic prophylaxis and regular checkups greatly reduce the risk of rheumatic heart disease.

Prevention: Protecting Your Family in Grand Rapids

Recognize and Treat Strep Throat Early

See a healthcare provider or urgent care in Grand Rapids if you or your child has:

  • Sore throat with fever
  • Painful swallowing
  • Swollen neck glands
  • Red, swollen tonsils, sometimes with white patches
  • No cough or runny nose (more typical of strep than a viral cold)

Local options include:

  • Primary care and pediatric clinics through Corewell Health, Trinity Health Grand Rapids, Metro Health – U of M Health, and Mercy Health
  • Urgent care centers and walk-in clinics throughout Kent County
  • Community health centers and school-based health programs supported by Kent County Health Department

Complete the Full Course of Antibiotics

If you are prescribed antibiotics for strep throat:

  • Take every dose as directed, even if you feel better in a few days
  • Do not share antibiotics or stop early
  • Follow up if symptoms do not improve within 48–72 hours

Improve Home and Community Health

  • Avoid sharing drinking glasses, utensils, or toothbrushes
  • Encourage regular handwashing, especially during the winter respiratory season
  • Keep up with routine healthcare visits and vaccinations
  • Seek help from local public health resources if you have trouble accessing care

Is There a Vaccine for Rheumatic Fever?

Currently, there is no vaccine specifically for rheumatic fever. Researchers in the United States and worldwide are working on vaccines that would prevent Group A Streptococcus infections, which could also prevent rheumatic fever and rheumatic heart disease.

Until then, early recognition and treatment of strep throat remain the most effective ways to protect children and adults in Grand Rapids.

When to Seek Help in Grand Rapids

Contact a healthcare provider or go to an urgent care or emergency department if:

  • Your child has sudden joint pain and swelling, especially if it moves from joint to joint
  • There is unexplained fever lasting more than a couple of days
  • You notice chest pain, shortness of breath, or heart palpitations
  • Your child develops unusual jerking movements or twitches
  • There is a history of rheumatic fever and new sore throat or fever appears

Local Resources

  • Primary Care & Pediatrics: Corewell Health, Trinity Health Grand Rapids, Metro Health – U of M Health, Mercy Health
  • Children’s Care: Helen DeVos Children’s Hospital (Corewell Health)
  • Public Health Support: Kent County Health Department, Grand Rapids Public Health programs

Key Points to Remember

  • Rheumatic fever is a complication of untreated or inadequately treated Group A strep infection, usually strep throat.
  • It most often affects children ages 5–14, but can occur at any age.
  • Without treatment, rheumatic fever can lead to rheumatic heart disease, which may permanently damage heart valves.
  • Most symptoms improve with medical treatment, but heart damage can be long-lasting if not caught early.
  • In some people, rheumatic heart disease causes no symptoms at first; in others, it leads to breathlessness, chest pain, and heart palpitations.
  • Prompt evaluation and treatment of sore throats in Grand Rapids—especially during the winter—are critical to preventing rheumatic fever and protecting heart health.