title: Incidence and clinical manifestations of rheumatic fever: a 6 year community-based survey.
abstract: BACKGROUND
  Most data on the incidence of rheumatic fever come from hospital records. We presumed that there may be cases of RF that do not require hospitalization, especially in countries with high quality community health care.
  
  
  OBJECTIVE
  To explore the incidence and characteristics of RF using community-based data.
  
  
  METHODS
  A retrospective descriptive study was conducted among the members (more than 450,000) of the Clalit Health Services, Central district, during 2000-2005. The electronic medical files of members up to 40 years old with a diagnosis of RF in hospital discharge letters or during community clinic visits were retrieved. Patients with a first episode of RF according to the modified Jones criteria were included.
  
  
  RESULTS
  There were 44 patients with a first episode of RF. All patients were under the age of 29. The annual incidence among patients aged 0-30 years was 3.2:100,000; the highest incidence was among children aged 5-14 years (7.5:100,000), and in males the incidence was 2.26 times higher than in females. The incidence was higher among patients from large families, of non-Jewish ethnicity, and from rural areas. Twenty-five percent of the patients were both diagnosed and treated in an ambulatory care setting.
  
  
  CONCLUSIONS
  Although the incidence of RF in the western world and in Israel is low, the disease still occurs and mainly affects children. Any future estimates of disease incidence should take into account that RF is becoming an ambulatorily treated disease.
authors.affiliation: Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. vinker01@zahav.net.il
authors.forename: Shlomo
authors.initials: S
authors.lastname: Vinker
authors.forename: Efrat
authors.initials: E
authors.lastname: Zohar
authors.forename: Robert
authors.initials: R
authors.lastname: Hoffman
authors.forename: Asher
authors.initials: A
authors.lastname: Elhayany
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000453:epidemiology* / Q000503:physiopathology