Rheumatic fever

Rheumatic fever is a serious illness, which in New Zealand most often affects Māori and Pacific children and young adults, aged 4–19 years.

This section provides information about what is being done by the Ministry, through its Rheumatic Fever Prevention Programme (RFPP), and by the health sector to address rheumatic fever. It also provides links to information for health professionals.


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What is rheumatic fever?

Rheumatic fever can develop after a ‘strep throat’ – a throat infection caused by a Group A Streptococcus (GAS) bacteria.

Most strep throats get better and don't lead to rheumatic fever. However, in a small number of people an untreated strep throat leads to rheumatic fever one to five weeks after a sore throat. This can cause the heart, joints, brain and skin to become inflamed and swollen.

While the symptoms of rheumatic fever may disappear on their own, the inflammation can cause rheumatic heart disease, where there is scarring of the heart valves.

People with rheumatic heart disease may need heart valve replacement surgery. Rheumatic heart disease can cause premature death in adults.

In 2014, 153 people were admitted to hospital for the first time with rheumatic fever.

Who gets rheumatic fever in New Zealand?

Māori and Pacific children and young adults (aged 4-19 years) have the highest rates of rheumatic fever. Māori children are about 20 times more likely to be hospitalised for rheumatic fever and Pacific children about 40 times more likely than non-Māori/non-Pacific children.

It is highly likely that a combination of crowded housing conditions and socio-economic deprivation, barriers to primary healthcare access and the subsequent higher burden of untreated strep sore throat infections are important factors leading to higher rates of rheumatic fever among Māori and Pacific people.

Rheumatic fever is unevenly distributed in New Zealand, with most cases recorded in the North Island.

What is happening to address rheumatic fever?

The Ministry of Health is working with other government agencies, health organisations, community and philanthropic groups, researchers and professional bodies to reduce New Zealand’s rheumatic fever rate.

The Ministry’s Rheumatic Fever Prevention Programme (RFPP) was established in 2011 to prevent and treat strep throat infections, which can lead to rheumatic fever. The Programme was expanded significantly from 2012 following the introduction of the rheumatic fever Better Public Services (BPS) target. The government has invested over $65 million to identify and trial new initiatives to reduce the rheumatic fever rates throughout New Zealand.

The Programme is working in the 11 District Health Board (DHB) areas with the highest incidence of rheumatic fever hospital admissions – Northland, Auckland, Counties Manukau, Waitemata, Waikato, Bay of Plenty, Tairāwhiti, Lakes, Hawke’s Bay, Hutt Valley and Capital & Coast DHBs.  High incidence DHBs are defined as those with three-year average baseline (2009/10 to 2011/12) incidence rates higher than 1.5 first episode rheumatic fever hospitalisations per 100,000 total population and a three-year average of four or more cases per annum.

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