Rheumatic fever is an illness that usually occurs in childhood. It is caused by an abnormal reaction to a common throat infection (tonsillitis caused by the bacteria streptococcus). You get usually get pain in and swelling of one joint after another and often damage to the heart. The valves inside the heart can be permanently damaged and this is termed Rheumatic heart disease. The average acute attack of rheumatic fever lasts 3 months. Having had one attack you are likely to have more unless you take regular penicillin until you are 25 years old. Heart failure due to the damage to the valves usually does not happen till many years later. Surgery on the heart valves can cure it. The territories where death rates are highest reflect where rheumatic fever is more common, the treatment of the initial illness is less satisfactory and there is failure to prevent recurrent attacks. In those territories successful surgery to the heart valves is likely to be unavailable to many.
Rheumatic heart disease caused 0.57% of all deaths worldwide in 2002, an average of 53 deaths per million people per year.