Ranked #1 — rheumatic heart disease

Think twice about brushing off sore throat
blue@samoanews.com
Highest rate of rheumatic heart disease cases in the world

American Samoa has knocked New Zealand from the #1 spot of having the highest incidents of rheumatic heart disease in the world. In response, a team from the Oregon Health and Science University (OHSU) based in Portland, OR arrived Monday night and will be treating local youngsters suspected of having rheumatic fever, rheumatic heart disease, or heart murmurs — free of charge.

The service is made possible, thanks to a generous donation of $12,000 from Paramount Builders owner Papalii Laulii Alofa, his wife Wanda, and their children. The check was presented to LBJ Hospital CEO Faumuina Taufetee Faumuina yesterday morning.

According to Mrs. Alofa, cases of rheumatic fever and rheumatic heart disease (RHD) are increasing in the territory and their company wants to take treatment efforts a step further, by gradually putting money into the cause, to purchase machines and equipment needed to carry out the service.

"This is just a little something to help out and to show the visiting team of specialists that we appreciate them coming here to help," she said.

In his brief remarks, Faumuina said the presence of the visiting medical team helps "ease the stress" on the LBJ staff and the families of those who are victims of rheumatic fever and RHD.

"Without this generous gift from Paramount Builders, this much needed service would not be available for the community," the LBJ CEO said. "We need help and the only option for some of the patients is off-island referral and we are not able to make that happen, continuously."

The six-member medical team includes three cardiologists: Dr. Laurie Armsby, Dr. Andrew Cave, and Dr. Erin Mandriago; two ultrasound technicians, Carrie Dishner and Heather Perry; and a nurse practitioner, Emma Olson.

Altogether, an estimated 150 patients are to be screened this week, before the group departs Friday night.

According to Dishner, for those with rheumatic fever, examinations will be conducted to check for progression, to determine if heart surgery is necessary.

Rheumatic heart disease (RHD) is a complication of rheumatic fever in which heart valves are damaged.

(A heart valve acts like a one-way door; it ensures that blood pumped by the heart flows in one direction only. Once it is damaged, it can leak and may cause the victim to feel tired all the time, and they may find it hard to breathe.)

Rheumatic fever is an inflammation that begins with strep throat and can affect other parts of the body, specifically the heart, joints, brain, and skin. It may cause permanent damage to heart valves and progress to RHD.

So the next time your little one complains of a sore throat, and the discomfort is in conjunction with a fever, medical assistance should be sought immediately.

What may seem like a common occurrence could lead to something more serious — if left untreated.

Antibiotics are the go-to remedy for strep throat. But once it progresses to rheumatic fever — and if left untreated — RHD is the result and while heart surgery may manage some of the problems and prolong life, it will not cure RHD.

In a brief interview with Samoa News yesterday morning, Dr. Laurie Armsby explained that strep throat is caused by a bacteria; however, bacteria is not what causes rheumatic fever and RHD. Instead, it is the body's immune system being 'revved up' to fight off the bacteria.

She said there are shots to keep RHD at bay but without full compliance with the prescribed treatment plan, patients risk getting sicker.

According to Dr. Armsby, the country with the highest rate for RHD cases in the world was New Zealand but recently, American Samoa became #1.

She said a study conducted back in 2012 determined that the territory had the highest incidents of RHD, based on criteria set forth by the World Health Organization (WHO).

Her solution to the problem: eradicate it by stopping the progression of strep throat.

"Strep throat is spread through a bacteria and for some reason, kids are more susceptible to getting it," Dr. Armsby said, adding that during one of her trips here, she and a team from OHSU visited several local private and public schools, conducting ultrasounds and echo scans on the little ones.

According to her, visits to American Samoa started back in 2010, and patients who were identified during past visits are called back for follow-ups, to determine if their condition is staying in range or progressing.

She said the most severe cases are referred off island for treatment.

"There needs to be a system in place to address this issue," Dr. Armsby said. "First, we must stress the importance of prevention. Also, there is a great need for funding and support. Nobody really knows why there is such a high rate of RHD in American Samoa."

In addition to visiting the territory for the RHD program, Dr. Armsby said they are available if LBJ's medical personnel ever need assistance. She cited an example where she was able to help diagnose two babies during a live stream over the Internet.

"This is what we want — to help out in any way we can," she concluded.

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