No previous documented acute rheumatic fever

Rheumatic heart disease (RHD) occurs only in someone who has had acute rheumatic fever (ARF). Timely and accurate diagnosis of ARF is critical to reducing the risk of RHD as it will allow sufficient time for secondary prophylaxis to be effective. This also relies on timely diagnosis and treatment of Strep A infections.

Among the 272 First Nations people with a new RHD diagnosis in 2022, 78% (213) did not have a previous ARF episode recorded on the registers or were diagnosed with RHD within 90 days of their recorded first ARF episode (Supplementary table 3.12). These data show that, in many cases, RHD could not have been prevented by secondary prophylaxis and highlight the importance of primordial and primary prevention.

ARF might not be recorded on a register for various reasons, such as any of the following:

  • being diagnosed before the relevant register began
  • being diagnosed prior to the condition being notifiable
  • the person being diagnosed in a jurisdiction that does not have a register
  • the episode was never diagnosed.