Information For | Pārongo Health Professionals Rheumatic Fever

Rheumatic Fever

Notification of rheumatic fever

Please notify all suspected and confirmed cases of rheumatic fever (both acute and recurrent attacks) to the Medical Officer of Health.  

Contact options:

Phone: 0800 221 555, select option 3

Email: Complete the Notifiable Diseases Form and email to CD.Admin@bopdhb.govt.nz

Urgent/After hours: 0800 221 555, select option 5

On-call Medical Officer of Health: 07 579 8000 (Tauranga Hospital)

Bay of Plenty and Lakes District Health Boards (DHB) areas have a high incidence of acute rheumatic fever.  Both DHBs now have plans aimed at reducing acute rheumatic fever.  As part of these plans, there are regular public rheumatic fever awareness campaigns.  A key message is ‘stop sore throats hurting hearts’. The underlying premise is that early diagnosis and treatment of strep throat will reduce the incidence of Acute Rheumatic Fever.

As a result of the campaigns, there may be an increase in the number of parents requesting throat swabs for their children. Consequently, we are also promoting the use of the Rheumatic Fever Guidelines published by the Heart Foundation.  

See below for the Bay of Plenty and Lakes DHB plans, information for GPs, links to the Rheumatic Fever Guidelines and information on the epidemiology of rheumatic fever in the Bay of Plenty and Lakes DHBs.

 

DHB Plans

 

Primary Care information

 

Heart Foundation - Rheumatic Fever Guidelines


Algorithm 1 to 4

 

Bay of Plenty DHB - clinical resources


Rheumatic Fever in the Bay of Plenty and Lakes district

Toi Te Ora Public Health Reports

 

Poster presentations

Rare symptoms

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Erythema marginatum

  • Highly specific to ARF
  • Cutaneous lesion: reddish pink borderpale centreround or irregular shape
  • Often on trunk, abdomen, inner arms or thighs
  • Highly suggestive of carditis

 

 

 

 

 

 

 

 

 

 


Subcutaneous nodules

  • Usually 0.5-2cm in diameter: Firm, non-tender, isolated or in clusters
  • Most common along on the extensor surfaces of the joint: knees, elbows, wrist
  • Also on bony prominences, tendons, dorsi of feet, occiput or cervical spine.
  • Last a few days only
  • Often associated with carditis 
     

 

 

 

 

 

 

Sydenham’s Chorea

  • Extrapyramidal disorder: 

  • Fast, clonic involuntary movements (especially face and limbs)

  • Muscular hypotonus

  • Emotional lability

  • First sign: difficulty walking, talking, writing

  • Usually a late manifestation, can be months after infection

  • May be the only manifestation of ARF

  • Often associated with carditis

  • Usually benign and resolves in 2-3 months

  • But can last for more than 2 years

Awareness campaigns

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Bay of Plenty rheumatic fever awareness campaign

Multi-media awareness campaigns ran between March to June from 2010 to 2017

 

Evaluation of the awareness campaigns

  

National rheumatic fever campaigns

View the Health Promotion Agency materials and resources used in the national campaigns.

Rheumatic fever e-learning course

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A free rheumatic fever e-learning course from the Ministry of Health is available at Learnonline.health.nz 

This user guide provides information on how to access the course.

The course is free and is aimed at primary care nurses, public health nurses and community health workers working with families whose children are at risk of developing rheumatic fever.  The course is also useful for locum general practitioners, general practitioners new to New Zealand and pharmacists.

Participants will receive a certificate showing they’ve successfully completed the two hour course.

Made up of four modules, the course includes information about:

  • rheumatic fever in New Zealand
  • how to identify people at high risk of rheumatic fever and how to assess and manage sore throats based on the identified risk
  • ways to reduce the transmission of sore throats within the household
  • how to identify the main symptoms and signs of rheumatic fever, as well as how it is typically managed

The course was developed in consultation with rheumatic fever experts, primary care nurses and community health workers.

School based throat swabbing programmes

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School based throat swabbing programmes are aimed at preventing rheumatic fever by detecting and treating streptococcal throat infection (‘strep throat’).

View the list of throat swabbing teams and services in the Bay of Plenty and Lakes.

Sandra Innes Smith is employed by Eastern Bay Primary Health Alliance (EBPHA) as the rheumatic fever clinical lead.

Contact Sandra.Innes-Smith@ebpha.org.nz for further information. 

Leanne Kirk is the co-ordinator of the Rotorua school based sore throat swabbing programme that operates out of Western Heights Health Centre.

Contact lkirk@raphs.org.nz for further information.

 

The rheumatic fever sector group

The rheumatic fever sector group (shown in the photo above) is committed to reducing rates of rheumatic fever in the Bay of Plenty and Lakes districts.

The sector teams meet together once per term to share information, resources and ideas.

The sector group consists of community health workers and nurses from:

  

Heart Foundation 'Sore Throats Matter' Teaching Units

The Heart Foundation developed teaching units for years 1-8 based on the NZ school curriculum's Health and Physical Education plan.

The aim of the Teaching units is to increase awareness of rheumatic fever prevention to children and teachers in high risk populations of NZ.

Read the Sore Throats Matter Teaching Kit.

Resources

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Health Promotion Agency resources

The Health Promotion Agency has a wide variety of rheumatic fever campaign material and resources for health workers and families.  

  • Click here to view resources from the 2014 - 2017 campaigns

 

Ministry of Health resources

  • Click here to view Ministry of Health learning resources

     

Heart Foundation resources

Rheumatic fever resources are available to order from the resource page of the Heart Foundation website 

 

5 messages to keep your family healthy

The 5 messages to keep your family healthy resources are aimed at reducing hospitalisations for preventable diseases such as rheumatic fever and skin infections.

Updated 18 Jan, 2021