Bull World Health Organ. 1978;56(6):887-912.
The public health importance of rheumatic fever is not directly related to its prevalence but is a complex function of many factors, such as incidence, prevalence, mortality, disability, and cost to the community, all relative to the importance of other diseases. Although the prevalence is low and still decreasing in developed countries, rheumatic fever is the commonest form of heart disease in many developing countries. Advances in the bacterial and serological characterization of group A streptococci are reviewed in this Memorandum, with emphasis on the nature of the structural elements of the cell wall. Microbiological methods play an important role in the diagnosis and control of rheumatic fever and up-to-date information is given concerning methods of isolation and grouping and of typing. Methods of assessing streptococcal activity in the host, in particular the different antibody responses found in relation to different pathological conditions, are discussed, as are the improvements required in laboratory services to enable them to carry out these duties adequately. Current concepts concerning the pathogenesis of rheumatic fever are reviewed together with differences in the epidemiology related to the different sites of infection and the problems of carriership. The Memorandum is also concerned with the methods of prevention and treatment, including prevention of recurrences, control of the disease in communities, and strategies for nationwide control.
风湿热对公共卫生的重要性并非直接与其患病率相关，而是多种因素的复杂函数，如发病率、患病率、死亡率、残疾情况以及对社区造成的成本，所有这些都相对于其他疾病的重要性而言。尽管在发达国家风湿热的患病率较低且仍在下降，但在许多发展中国家它却是最常见的心脏病形式。本备忘录回顾了A组链球菌细菌学和血清学特征方面的进展，重点是细胞壁结构成分的性质。微生物学方法在风湿热的诊断和控制中发挥着重要作用，文中给出了关于分离、分组和分型方法的最新信息。讨论了评估宿主中链球菌活性的方法，特别是与不同病理状况相关的不同抗体反应，以及实验室服务为充分履行这些职责所需的改进。回顾了关于风湿热发病机制的当前概念，以及与不同感染部位相关的流行病学差异和带菌问题。本备忘录还涉及预防和治疗方法，包括预防复发、社区疾病控制以及全国范围控制策略。
