Authors:
Noonan S, Zurynski YA, Currie BJ, McDonald M, Wheaton G, Nissen M, Curtis N, Isaacs D, Richmond P, Ramsay JM, Elliott EJ, Carapetis JR
Authors notes:
Pediatric Infectious Disease Journal. 2013;32(1):e26-e32
Keywords:
Australia, children, rheumatic fever, surveillance, infectious disease
Abstract:
Acute rheumatic fever (ARF) is an important cause of heart disease in Indigenous people of northern and central Australia.
However, little is known about ARF in children across all Australian population groups.
This national prospective study was conducted to determine patterns of disease, and populations and regions at highest risk.
ARF was identified in 151 children: 131 Indigenous Australians, 10 non-Indigenous Australians, 8 Pacific Islanders and 1 African (1 unknown).
Seven non-Indigenous Australian children presented with classic, highly specific features compared with 23% of high-risk children, suggesting that subtle presentations of ARF are being missed in non-Indigenous children.
Recent sore throat was reported in 33% of cases, including 25% of remote Indigenous children.
There were delays in presentation to care and referral to higher-level care across urban/rural and remote areas.
ARF may be more common than previously thought among low-risk children.
These data should prompt an awareness of ARF diagnosis and management across all regions, including strategies for primary prevention.
There should be renewed emphasis on treatment of sore throat in high-risk groups.