Vuković D
Srp Arh Celok Lek. 1991 May-Jun;119(5-6):162-5.
Two contradictory changes related to rheumatic fever existed in the 80's. A constant, almost dramatic fall of rheumatic fever incidence occurred in the second half of the 80's. This fact was explained by improvement of living conditions and way of life, as well as by a developed health service. But, unexpectedly, a sudden rise of rheumatic fever incidence occurred in many states of the United States of America in that period. The medical experts were reminded that similar danger might also be expected in other countries. This increase of rheumatic fever incidence was followed by severe forms of the disease. In the 80's intensive epidemiologic, microbiologic and molecular researches of the beta haemolytic streptococcus A and parallel genetic investigations of the population with rheumatic fever, were undertaken. The aim of these studies was to discover the rheumatogenic factor in the streptococcus and to differentiate it from the immunogenic one, as well as to detect the genetic factor in the sick people. In this way these findings would be the best contribution to the knowledge of the pathogenesis of rheumatic fever and to a more efficacious protection (vaccination).
20世纪80年代存在与风湿热相关的两种相互矛盾的变化。在80年代后半期,风湿热发病率持续且几乎急剧下降。这一现象被归因于生活条件和生活方式的改善以及发达的医疗服务。然而,出乎意料的是,在那个时期,美国许多州的风湿热发病率突然上升。医学专家们被提醒,其他国家也可能存在类似的风险。风湿热发病率的上升伴随着该疾病的严重形式。在80年代,针对A组β溶血性链球菌开展了密集的流行病学、微生物学和分子研究,并对风湿热患者群体进行了平行的遗传学调查。这些研究的目的是在链球菌中发现致风湿因子,并将其与免疫原性因子区分开来,同时检测患者体内的遗传因子。通过这种方式,这些研究结果将为了解风湿热的发病机制以及提供更有效的保护(疫苗接种)做出最佳贡献。