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The diagnosis of acute rheumatic fever relies on a combination of clinical evaluation and laboratory studies. Diagnosis is usually made using the Jones criteria, which have recently been updated in 2015.

Jonathan Judy Alex Jeffrey Rosemary Carapetis AM Katzenellenbogen Brown Cannon Wyber AM MBBS FRACP FAFPHM PhD FAHMS BSc (Occ Ther) BSc Hons (

Jonathan Rosemary Carapetis AM Wyber AM MBBS FRACP FAFPHM PhD FAHMS MBChB MPH FRACGP PhD Co-Head, Strep A Translation; Co-Founder of REACH Senior

We have read with interest the new publication by Rouhiainen and colleagues on missed opportunities for preventing or diagnosing acute rheumatic fever (ARF).

Jonathan Carapetis AM AM MBBS FRACP FAFPHM PhD FAHMS Co-Head, Strep A Translation; Co-Founder of REACH 08 6319 1000 contact@thekids.org.au Head,

Fear of severe adverse reaction (SAR) and reluctance of health care providers to administer intramuscular injections are major contributing factors to poor adherence of benzathine penicillin G (BPG) in the management of rheumatic heart disease (RHD). However, data on the risk of SARs following BPG injections for RHD are relatively limited and inconclusive. Our systematic review and meta-analysis aimed to evaluate the incidence of SARs associated with BPG injections used for secondary prophylaxis of RHD. 

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are prevalent among First Nations peoples in Australia. In Western Australia (WA), notification of ARF and RHD to the WA RHD register is mandatory and supports follow-up care. However, previous studies from rural WA have reported incomplete notification, suggesting gaps in surveillance and hospital-registry linkage.

Here we describe the experiences of young people living with ARF participating in a Phase-II trial of SubCutaneous Injections of BPG.

Scabies is one of the world’s most prevalent diseases, with approximately 147 million cases at any one time and an estimated annual incidence of 455 million new episodes. Although Group A streptococcal (GAS) pharyngitis has long been implicated in the pathogenesis of acute rheumatic fever (ARF) and subsequent rheumatic heart disease (RHD), impetigo caused by GAS has recently been postulated as a link between scabies and the pathogenesis of ARF.

A team led by Dr Joseph Kado from the Wesfarmers Centre of Vaccines and Infectious Diseases, based at The Kids Research Institute Australia, and The University of Western Australia (UWA) has been awarded $5 million by the Federal Government in a major push to prevent rheumatic heart disease across the Pacific.