About rheumatic fever

Most strep throats get better and don't lead to rheumatic fever. However, in a small number of people an untreated strep throat leads to rheumatic fever one to five weeks after a sore throat. This can cause the heart, joints, brain and skin to become inflamed and swollen.

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.

People with rheumatic heart disease may need heart valve replacement surgery. Rheumatic heart disease can cause premature death in adults.

Who gets rheumatic fever in New Zealand?

Māori and Pacific children and young adults (aged 4–19 years) have the highest rates of rheumatic fever. 

It is highly likely that a combination of crowded housing conditions and socio-economic deprivation, barriers to primary healthcare access and the subsequent higher burden of untreated strep sore throat infections are important factors leading to higher rates of rheumatic fever among Māori and Pacific people.

Rheumatic fever is unevenly distributed in New Zealand, with most cases recorded in the North Island.

How New Zealand is addressing rheumatic fever

The RFPP was established in 2011 to prevent and treat strep throat infections, which can lead to rheumatic fever. The programme was expanded significantly from 2012 following the introduction of the five-year rheumatic fever Better Public Services target. The government invested about $65 million to identify and trial new initiatives to reduce the rheumatic fever rates throughout New Zealand.

Although the RFPP ended on 30 June 2017, rheumatic fever prevention continues to be a focus for the 11 DHBs with a high incidence of rheumatic fever. The Ministry continues to work closely with hospitals in Northland, Auckland, Counties Manukau, Waitemata, Waikato, Bay of Plenty, Hauora Tairāwhiti, Lakes, Hawke’s Bay, Hutt Valley and Capital & Coast.

High incidence DHBs are defined as those with three-year average baseline (2009/10 to 2011/12) incidence rates higher than 1.5 first episode rheumatic fever hospitalisations per 100,000 total population and a three-year average of four or more cases per annum.

The Ministry continues to work with other government agencies, health organisations, community and philanthropic groups, researchers and professional bodies to reduce New Zealand’s rheumatic fever rate.

The Rheumatic Fever Prevention Programme (RFPP)

The Rheumatic Fever Prevention Programme (RFPP) had three main strategies to reduce rheumatic fever rates throughout New Zealand:

  • increase awareness of rheumatic fever, what causes it and how to prevent it
  • reduce household crowding and therefore reduce household transmission of strep throat bacteria within households
  • improve access to timely and effective treatment for strep throat infections in priority communities.