Reducing rheumatic fever

In 2024, there were 199 people admitted to hospital for the first time with rheumatic fever (3.74 per 100,000 people) in New Zealand. This is an increase of 17 people compared to 2023 (3.48 per 100,000 people). 

Following a decrease between years 2011 to 2015, there was a stabilisation in the rate of Māori admitted to hospital for the first time with rheumatic fever. Over the last ten years, this rate has fluctuated between 5.6 and 9 per 100,000 people.

Hospitalisations for Pacific peoples fluctuated between 2011 and 2018. During 2019 to 2022, there was a decrease in hospitalisations from 27.73 per 100,000 people (94 cases) in 2019 to 8.04 per 100,000 people (29 cases) in 2022. Over the last two calendar years, this has increased to 30.56 per 100,000 people (114 cases) in 2024. This is an increase of 10.2% compared to 2019.

An insights report was completed in 2024, which provided analysis of rheumatic fever and rheumatic heart disease through the COVID-19 pandemic in New Zealand. This work was led by Tōmaiora, researchers from the University of Auckland. Key findings included significant decreases in crude acute rheumatic fever hospitalisation rates in 2021-2022, however marked inequities still persisted for Māori and Pacific peoples. The COVID-19 elimination-suppression strategy had a significant independent effect in a best fit model, associated with a reduction in acute rheumatic fever hospitalisations by 50%.

It is not surprising to see an increase in rheumatic fever hospitalisations, given what has occurred with other childhood respiratory infections (viral, invasive pneumococcal disease etc.) during the pandemic, with infection rates initially falling then now rising again. Health New Zealand will continue to watch the situation closely.

It is also important to note that while Aotearoa has higher rates of rheumatic fever compared to other development countries, the annual numbers are small. Therefore, changes year-to-year may be real, or they may be an artifact of the variability that is seen when there are small numbers of cases.

A five-year Rheumatic Fever Roadmap was launched in June 2023. The purpose of the Roadmap is to reset and refocus efforts around rheumatic fever and rheumatic heart disease prevention, identification and management, and sets out existing and new priority actions and opportunities for investment in the coming years. 

The three focus areas of the Roadmap include:

1. Whānau Ora – determinants of wellbeing and primary prevention.
2. Tāngata Ora – quality health care and improved journey through the health system for those with rheumatic heart disease and rheumatic fever.
3. Kōkiri Ngātahi – system readiness and change.

The Roadmap is available below.