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February 1963

Declining Severity of First Attack of Rheumatic Fever

Author Affiliations

Eugenie F. Doyle, M.D., Department of Pediatrics, New York University Medical Center, 550 1st Ave., New York 16, N.Y.; Assistant Clinical Professor of Pediatrics (Dr. Mayer); Associate Professor of Pediatrics (Dr. Doyle); Instructor, Department of Medical Statistics (L. Herrera); Assistant Professor of Clinical Pediatrics (Dr. Brownell).; From the Departments of Pediatrics and Medical Statistics, New York University Medical Center.

Am J Dis Child. 1963;105(2):146-152. doi:10.1001/archpedi.1963.02080040148004

A decline in the incidence and severity of rheumatic fever has been reported from several centers in the past 2 decades.1-11 It is the purpose of this report to document this trend as it has occurred on the Children's Cardiac Service at Bellevue Hospital over a 24-year period from 1935 through 1958.

Case Material and Methods  A total of 792 initial attacks of acute rheumatic fever form the basis for this study. The patients, ranging in age from 2 to 15 years, fulfill the following requirements: (1) They were hospitalized atBellevue during their first attack, and (2) a definite diagnosis of acute rheumatic fever was made in each. Cases in which the diagnosis of acute rheumatic fever was considered to be questionable at the time of review for the study were not included. A definite diagnosis required at least one of the major criteria of Jones12,13 (arthritis,