Playing a role in the prevention of rheumatic fever and rheumatic heart disease

The incidence of acute rheumatic fever (ARF) and the prevalence of rheumatic heart disease (RHD) among Aboriginal and Torres Strait Islander people are among the highest in the world.

ARF is caused by an auto-immune reaction to an infection with group A streptococcus (GAS). ARF is a short illness but can result in permanent damage to the heart valves. This is known as rheumatic heart disease (RHD).

People who have had ARF once are susceptible to repeated episodes, which cause further cardiac valve damage.

Following an initial diagnosis of ARF, patients require long-term treatment with antibiotics (antibiotic prophylaxis) to avoid recurrences. Best-practice ARF prophylaxis requires IM Bicillin LA every 21 to 28 days. However, the number of patients receiving all of their scheduled 13 injections per year is still too low. The majority of patients receive between zero and 49 per cent of their injections.

ARF is a notifiable disease in Queensland and most other States and Territories, meaning that health practitioners must inform the relevant Department of Health when a patient is diagnosed with ARF.

Funded under the Australian Government’s Rheumatic Fever Strategy, the RHD Register and Control Program in Queensland (RHD Program QLD) is a State-wide service to monitor ARF and RHD and to provide support to healthcare providers.

Program activities are based around notification of ARF and a State-wide database for disease and treatment monitoring that contains details of demographics, diagnosis and treatment for patients suspected or diagnosed with ARF and RHD. The database currently covers 2,500 clients, over 1,800 of whom are being actively treated. The database can provide data for disease surveillance and research support.

There is a recall and reminder system under which regular Bicillin recall notices are send out to all facilities with ARF and RHD patients in their care. A similar echocardiogram recall notice is send out quarterly.

The Program also provides education and clinical advice to patients (mainly when newly diagnosed), family, healthcare providers and the community.

Contact RHD Program QLD by phone on 1300 135 854 or email [email protected]

Similar RHD Programs exist in other States and Territories: Northern Territory (08 8922 8454), Western Australia (1300 622 745), South Australia (08 7425 7146), and New South Wales (02 9461 7073).

More information is available at www.RHDaustralia.org.au

The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (2nd ed, 2012) is available for download via www.RHDaustralia.org.au and as a free app from GooglePlay/AppStore