Rheumatic fever

Rheumatic fever is a serious but preventable illness. It mainly affects Māori and Pacific children and young people (aged 4 and above), especially if they have other family members who have had rheumatic fever.


Sore throats need checking

Rheumatic fever starts with a sore throat that is known as ‘strep throat’ – a throat infection caused by a bacteria called Group A Streptococcus.

Most sore throats get better on their own, but if strep throat is not treated with antibiotics it can cause rheumatic fever in at-risk children. Because rheumatic fever is such a serious illness, all sore throats in Māori and Pacific children and young people (aged 4 and above) need to be checked. 

Effects of rheumatic fever

Rheumatic fever makes the heart, joints (elbows and knees), brain and skin swollen and painful.

Rheumatic fever is an ‘autoimmune disease’, which means there is a problem with the immune system (the cells and organs that protect the body against illnesses and infections).

Rheumatic fever happens when your child’s immune system makes a mistake and attacks your child’s heart instead of the germs from an illness.

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. Rheumatic heart disease can be life threatening.

If your child has rheumatic fever

If your child develops rheumatic fever they will need a lot of bed rest and time off school. They’ll need to stay in hospital for weeks, where they will have examinations and blood tests to check their condition.

Rheumatic fever can affect your child’s life, making it more difficult for them to play sport or do other activities as they will have less energy.

Rheumatic heart disease

If your child has more attacks of rheumatic fever then they may develop rheumatic heart disease. This can cause serious heart problems, damaging your child’s heart forever. Your child may need heart surgery.

Find out more from the Ministry

Information about what the Ministry and the health sector are doing to address rheumatic fever in New Zealand. – Rheumatic fever


Rheumatic fever usually starts 1–5 weeks after your child has had strep throat.

Your child may develop:

  • sore and swollen joints (knees, elbows, ankles and wrists). Joints may feel hot as well; different joints may be sore on different days
  • an ongoing fever that lasts a few days.

If your child has these symptoms take them to the doctor or nurse straight away to get them checked.

They may also have:

  • stomach pains
  • extreme tiredness
  • weight loss
  • an unusual-looking rash on their body, arms and legs.


Because rheumatic fever starts with a sore throat, it’s important that your child’s sore throats get checked. If your child is Māori or Pacific, is aged 4 and above, and has a sore throat, please get it checked straight away.

If your child has strep throat, they’ll be given antibiotics to clear up the infection before it can develop into rheumatic fever.

Where to get your child checked

There are lots of places you can get a sore throat checked.

  • You can go to your normal doctor or nurse. You may have to pay a fee, you can phone ahead to check.
  • Your child’s school may have a sore throat checking programme in place (contact the school to find out) – this service is free.
  • If you’re in the Northland, Auckland, Lakes, Waikato, Bay of Plenty, Gisborne/East Coast, Hawke’s Bay, Porirua or the Hutt Valley areas, and your child fits the criteria above, they can have their throat checked at a free sore throat clinic. You can also call Healthline on 0800 611 116 to find a clinic near you.

If your child is given antibiotics it’s important they take the full ten day course, even if they feel better, to stop the sore throat turning into rheumatic fever.

Living with

Rheumatic fever is likely to come back in people who don’t take low-dose antibiotics continually, especially in the first 3–5 years after the first episode of the disease. Your child will need extra medical care for many years, including 10 years of monthly penicillin (antibiotic) injections.

Heart problems

Depending on how serious the first episode of the disease is, some children may develop heart disease. They may not be able to exercise or play sports – talk to your doctor about what is best for your child.

Heart complications may be serious, particularly if the heart valves are involved. If your child develops heart disease, they will need care from a cardiologist (heart doctor).

Dentist visits

Some children may need antibiotics before having dental work done. This helps reduce the chance of infection reaching the heart during the dental procedure. Talk to your child’s doctor or dentist for more information.

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