Heart-to-heart: Sore throats are killing

chandigarh: a disease which can be cured in its early stages simply by a course of the earliest known antibiotic penicillin continues to claim young lives under the sway of ignorance and negligence. few parents suspect that a seemingly innocuous sore throat infection can leave heart valves severely damaged.but that is how rheumatic heart disease (rhd) strikes children.‘‘parents initially ignore rheumatic fever, leading to complications,’’ says naresh trehan, cardiologist at escorts heart institute, new delhi. doctors say if the disease is rightly diagnosed in the ‘sore throat’ stage, it can be cured by administering penicillin. however, most cases of ‘red throat infection’ turn up in the advanced stages, by when damage to the heart valves has already occurred. replacing damaged heart valves is an expensive operation, requiring rs 70-80,000. slum dwellers, whose children are most prone to the infection due to various factors, can ill afford to spend so much on treatment. ‘‘their attitude is, it does not matter if one of our five children dies,’’ says sudha gupta, a social worker at pgi. she recalls instances of people having several children refusing to get a child with heart disease treated. as a result, the mortality rate due to rhd continues to be high in slums. congestion, poverty and unhygienic conditions, all of which characterise slums, are known to aid the spread of infection. anil grover, head of pgi’s cardiology department, points to the correlation between the growth of slums in the country and the rising incidence of rhd. cases of rhd among children have also been registered in the slums and rural areas around the city. pgi’s cardiology department has been monitoring cases of rhd in raipur rani village, near panchkula, since 1991. during the period, it detected 102 cases in the 5-15 years age group. of these, 57 have ended in death. in another study conducted by the department of community medicine in the rural blocks of ambala, between 1988-1999, 132 rhd or rheumatic fever (rf) cases were detected in a similar age group. fifty two ended in death. besides the ignorance of parents, dependence on general medical practitioners is also seen as a reason for rhd. sudha gupta says it is difficult to convince parents to see specialists. on the other hand, there are not many specialists around. ‘‘even pgi does not have a single paediatrics cardiologist. in fact, there are few in the entire country,’’ laments anil narang, head of pgi’s advanced paediatric centre.