Sore throat management

How to identify patients at high or low risk of acute rheumatic fever.

New Zealand has high rates of acute rheumatic fever (ARF). If not prevented, the implications for a child and their whanau of this diagnosis is devastating, with monthly bicillin injections, and possible heart surgery and premature death.  

The Heart Foundation revised its guidelines in 2019 to target the individuals who are most at risk of developing acute rheumatic fever following a group A streptococcal (GAS) sore throat. 

Objectives of this course:

• To identify patients at high risk for rheumatic fever (to enable primary prevention strategies).
• To identify patients at low risk of rheumatic fever (to reduce unnecessary antibiotic use).
• To understand the management of high-risk patients.
• To understand the management of low-risk patients and the exceptions where there is an increased risk of spread of GAS.
• To understand when household swabbing is required.

Acknowledgements

This content was created by Dr Karen Falloon PhD, MBChB, FRNZCGP, and updated by Dr Vicki Mount, BSC/BCom, MBChB, MRNZCGP, DipPaeds.