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Epidemiology

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Incidence is related to socioeconomic status and crowding:

  • incidence is highest in 5 to 15 year olds
  • outbreaks can occur in closed communities
  • annual incidence in developed countries 0.6 per 100,000 children
  • incidence in children in Kuwait is 29 per 100,000
  • seasonal incidence follows that of streptococcal pharyngitis
  • mortality from initial attack - less than 1%
  • chronic rheumatic heart disease occurs in more than 50% of those suffering an acute attack
  • 0.3-3% of children with group A streptococcal pharyngitis subsequently develop rheumatic fever

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