title: Rheumatic fever - identification, management and secondary prevention.
abstract: BACKGROUND
  Acute rheumatic fever is a rare multisystem disease caused by an immunological response to Group A streptococcus infection. Acute rheumatic fever usually has onset in childhood and is most prevalent in Aboriginal and Maori populations and other disadvantaged groups.
  
  
  OBJECTIVE
  In this article we outline the clinical features of acute rheumatic fever and describe the important role of primary healthcare providers in its identification, management and secondary prevention.
  
  
  CONCLUSIONS
  Recurrent episodes of acute rheumatic fever may lead to rheumatic heart disease. Early detection of acute rheumatic fever and provision of secondary prophylaxis with antibiotics is paramount to the prevention of rheumatic heart disease. Primary healthcare providers can play an important role in identifying acute rheumatic fever and ensuring adherence to treatment within the context of a complex interplay of cultural and socioeconomic factors. The recent establishment of RHD Australia will support the development of appropriate educational resources and their dissemination among health professionals and vulnerable communities.
authors.affiliation: Australian Paediatric Surveillance Unit, The Children's Hospital at Westmead, Sydney, New South Wales. msmi8455@uni.sydney.edu.au
authors.forename: Michael T
authors.initials: MT
authors.lastname: Smith
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Zurynski
authors.forename: David
authors.initials: D
authors.lastname: Lester-Smith
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Elliott
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carapetis
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D006801:Humans; D012213:Rheumatic Fever / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology / Q000628:therapy; D012214:Rheumatic Heart Disease / Q000517:prevention & control*; D055502:Secondary Prevention / Q000379:methods*; D013290:Streptococcal Infections / Q000150:complications* / Q000276:immunology