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In the 12 months ending 31 December 2022, there were 82 people admitted to hospital for the first time with rheumatic fever (1.6 per 100,000) in New Zealand. This is a decrease from 93 people in the 12 months ending 31 December 2021 (1.8 per 100,000).

First episode rheumatic fever hospitalisations, annual rate per 100,000, New Zealand, 2006 - 2022

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from calendar years 2006 to 2022. The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from calendar years 2006 to 2022. The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from calendar years 2006 to 2022.

First episode rheumatic fever hospitalisations, annual rate per 100,000, New Zealand, 2006 - 2022

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from calendar years 2006 to 2022.

First episode rheumatic fever hospitalisations, annual rate per 100,000, by ethnic group, New Zealand, 2009 - 2022

First episode rheumatic fever hospitalisations, annual rate per 100,000, by ethnic group, New Zealand, 2009 - 2022 First episode rheumatic fever hospitalisations, annual rate per 100,000, by ethnic group, New Zealand, 2009 - 2022 First episode rheumatic fever hospitalisations, annual rate per 100,000, by ethnic group, New Zealand, 2009 - 2022

Following a decrease between years 2011 to 2016, there was a stabilisation in the rate of Māori admitted to hospital for the first time with rheumatic fever between 2016 and 2020. Since 2020, Māori rates have decreased from 8.7 per 100,000 (74 cases) in 2020 to 5.5 per 100,000 (49 cases) in 2022 (5.5 per 100,000). This represents an approximately 34% decrease in cases since 2020.

Hospitalisations for Pacific people fluctuated between 2011 and 2019, however there has been a large decrease in Pacific people admitted to hospital for the first time with rheumatic fever since 2020. Since 2020, Pacific rates have decreased from 19.5 per 100,000 (69 cases) in 2020 to 8.2 per 100,000 (30 cases) in 2022. This represents an approximately 57% decrease in cases since 2020. This decrease has been largely driven by a reduction in hospitalisations for Pacific people in Counties Manukau.

Work is currently underway to understand the contributing factors that have led to this decrease. Specifically, it is crucial to understand if this is a true decrease or under-ascertainment due to reduced access to acute care associated with the COVID-19 pandemic and response. In addition, it is important to identify any factors working well at present in rheumatic fever prevention, that can be sustained going forward.

We note that the annual cases for Pacific people in 2022 have increased slightly compared to 2021. It is not surprising to see a slight 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. Te Whatu Ora will continue to watch the situation closely.

It is also important to note that while Aotearoa has a high incidence of rheumatic fever, the annual numbers are small compared to other illnesses. 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.

The following table shows the numbers and rates of people being admitted to hospital with rheumatic fever for the first time in 2022 by age group. It shows that the majority of cases continue to occur in children between 5 and 14 years.

First episode rheumatic fever hospitalisations, rate per 100,000, by age group, 2022

The table below details the rheumatic fever rates in 2022 by Te Whatu Ora District (formerly District Health Board region).

 

Numbers

Rate per 100,000

0–4 years

1

0.3

5–14 years

58

8.8

15–24 years

8

1.2

25–44 years

13

0.9

45+ years

2

0.1

First episode rheumatic fever hospitalisations, rate per 100,000, by Health District, 2022

Health District

(formerly DHB region)

Numbers

Rate per 100,000

Northland

5

2.5

Waitemata

7

1.1

Auckland

7

1.5

Counties Manukau

30

5.0

Waikato

6

1.3

Lakes

<4

-

Bay of Plenty

6

2.2

Hauora Tairāwhiti

5

9.6

Taranaki

<4

-

Hawke’s Bay

<4

-

Midcentral

<4

-

Whanganui

0

0.0

Capital & Coast

<4

-

Hutt Valley

<4

-

Wairarapa

<4

-

Southern region

<4

-

 

Source: National Minimum Dataset

Note: Rates have not been calculated where there were fewer than four cases. This is because the small numbers will result in unreliable estimates of rates.

Where to from here?

Over the past decade there have been a range of rheumatic fever prevention programmes and activities, including the Rheumatic Fever Prevention Programme (RFPP) between 2017- 2022, that focussed on sore throat management and access to care, healthy housing and raising awareness.

Following the end of the RFPP each high-incidence region/district received funding to continue focussing on rheumatic fever prevention, and from 1 July 2022 rheumatic fever prevention should be embedded into ongoing delivery of services.

 A five-year Rheumatic Fever Roadmap will be launched in June 2023 which will set out priority actions and opportunities for investment in coming years. The Roadmap will be available on the Te Whatu Ora website for download from mid-June 2023.

Download: Rheumatic Fever Report 2022 - XLSX, 40 KB

Rates and numbers are available for the New Zealand population, by ethnic group and for district health board.

Download: Rheumatic Fever Roadmap, 2023 - 2028 - PDF, 9.3 MB

The Rheumatic Fever Roadmap, 2023 – 2028 has been developed to reset, renew and amplify efforts in Aotearoa New Zealand to tackle rheumatic fever.