Acute Rheumatic Fever in Shiraz, Iran

THE PREVALENCE of rheumatic fever in Iran has not been reported, although reports have appeared from other Eastern countries.¹⁻¹⁷The decline in the prevalence and severity of acute rheumatic fever in several Western nations⁹,¹⁰has been explained, at least in part, by improving standards of living in these countries. The purposes of this paper are to report the prevalence of rheumatic fever and the frequency of its manifestations on the pediatric wards of the Pahlavi University Hospitals, and to examine the widely held impression that rheumatic fever and rheumatic heart disease are most frequent in areas where malnutrition, poverty, and crowding are present.¹¹ Clinical Materials Shiraz is a city of 250,000 in southern Iran at a latitude of 29°36′ and on a plateau at an elevation of 5,100 feet. The mean temperature during the period of study varied from 38 to 42 F in January to 85