Rheumatic fever in New Zealand
Article first published online: 3 NOV 2011
© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 3, pages 179–184, March 2013
How to Cite
Webb, R. and Wilson, N. (2013), Rheumatic fever in New Zealand. Journal of Paediatrics and Child Health, 49: 179–184. doi: 10.1111/j.1440-1754.2011.02218.x
- Issue published online: 10 MAR 2013
- Article first published online: 3 NOV 2011
- Accepted for publication 2 June 2011.
- rheumatic fever;
- rheumatic heart disease
Acute rheumatic fever and its sequel rheumatic heart disease remain major unsolved problems in New Zealand, causing significant morbidity and premature death. The disease burden affects predominantly indigenous Māori and Pacific Island children and young adults. In the past decade these ethnic disparities are even widening. Secondary prophylaxis using 28-day intramuscular penicillin has been the mainstay of disease control. In the greater Auckland region, audit shows community nurse-led penicillin delivery rates of 95% and recurrence rates of less than 5%. The true penicillin failure rate of 0.07 per 100 patient years supports 4 weekly penicillin rather than more frequent dose regimens. Landmark primary prevention research has been undertaken supporting sore throat primary prevention programmes in regions with very high rheumatic fever rates. Echocardiographic screening found 2.4% previously undiagnosed rheumatic heart disease in socially disadvantaged children. Combined with secondary prevention, echocardiography screening has the potential to reduce the prevalence of severe rheumatic heart disease.