Special Episode 15. Rheumatic Fever with Dr Alex Tai

Acute Rheumatic fever (ARF) is a multisystem disease caused by an immunological response to Group A streptococcal infection leading to Rheumatic heart disease (RHD) and is responsible for 250,000 deaths per year worldwide, predominantly in young people. It is estimated that 15 million people across the globe have evidence of Rheumatic heart disease. In Australia, the estimated incidence is reflective of ethnicity with 65 per 100 000 infections among Aboriginal and Torres Strait Islander people compared with 3 per 100 000 for other Australians. Consequently, 92% of the ARF reported is among Aboriginal and Torres Strait Islander people, mostly affecting children aged 5-14 years with rates of ARF and Rheumatic heart disease highest across northern and central Australia.

Recent research has found that Aboriginal and or Torres Strait Islander people are ten times more likely and Pacific Islander people 82 times more likely to have an episode of ARF than other ethnicities.

Although more than 9000 people are on RHD registers across Australia currently very little is known about the epidemiology of ARF and RHD in southern regions of Australia despite an estimated 57% of the Aboriginal and Torres Strait Islander population living in these regions. Importantly on 31st July this year, acute rheumatic fever and rheumatic heart disease became routine notifiable conditions in Victoria with only Tasmania and the ACT left to enact this important policy.

A new case of ARF is recognised to be 10 times more common in an individual with a past episode of ARF than an individual from the same community without prior ARF underscoring how important disease notification is for secondary prevention. Presently 80 % of people diagnosed with ARF have no prior diagnosis registered.

It was a real honour to welcome back expert infectious diseases specialist Alex Tai who has been passionate about education and bringing forth new issues of an infectious nature for our understanding. It gives me great pleasure to welcome Alex back to Everyday Medicine to discuss this important topic further.

References:

Dr Alex Tai - Gippsland Region Public Health Unit - Monash University. - Baw Baw Physicianshttps://www.bawbawphysicians.com.au › ...Dr Alex Tai - Infectious Diseases Physician

Dr Alex Tai - LinkedIn

Notification of Rheumatic Heart Disease and Acute Rhematic Fever. https://www.health.vic.gov.au/health-advisories/notification-of-rheumatic-heart-disease-and-acute-rhematic-fever

National Treatment Guidelines - www.rhdaustralia.org.au/arf-rhd-guidelines