Rheumatic Fever in Western Fiji: The Female Preponderance

In western Fiji, 70% of the Indian patients suffering from rheumatic fever and acute tonsillitis are female. Although other respiratory infections affect the sexes equally, ail these diseases tended to affect the girls at later ages than the boys. Evidence from India and Natal shows that genetic factors per se are not of importance. Evidence is presented which relates these findings to the cloistered upbringing of many of the Indian girls. The more sheltered a girl's childhood, the greater appears to be her risk of developing rheumatic fever, and the later its onset. It appears that infrequent respiratory infections in early life may affect the immune system in such a way as to make rheumatic fever and acute tonsillitis occur more frequently, with a tendency to develop later.