The only manifestation of ARF with potentially life-threatening and permanent sequelae is the carditis- as evident either as valvulitis( the precursor to rheumatic heart disease) pericarditis and myocarditis.ie a pancarditis.
The natives of Hawaii were Black people whose ancestral roots extend back to Africa. Prince Leleiohoku (1855-1877), Crown Prince of the Hawaiian Islands. Had he not died of rheumatic fever at age 23, his abundant talent promised that his would have been a brilliant musical career. His excellent songs are still being sung, among them " Adios Ke Aloha", and "Moani Ke Ala". The melodic line from "Kaua I Ka Huahua`i" was later adopted for the modern "Hawaiian War Chant."