NZPHR Vol 8 No 6 Jun 2001
Tuesday 7th September 2010
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Contents and Lead Article
Contents- Rheumatic fever registers in New Zealand
- Outbreak of Salmonella Typhimurium phage type 160 in Auckland linked to an umu function
- Hospitalisations and fatalities from notifiable communicable diseases in 2000
- Surveillance and control notes
Rheumatic fever registers in New Zealand
This paper reports 1995-2000 acute rheumatic fever (ARF) rates and the results of surveys of register-based prevention programmes in New Zealand conducted in 1996, 1998 and 2001. New Zealand continues to have high rates of ARF for an industrialised country. Individuals who have had ARF are at increased risk of further episodes (recurrent ARF), which increase progression to chronic rheumatic heart disease (CRHD). Regular delivery of antibiotic prophylaxis prevents recurrent ARF and reduces progression to CRHD. Disease registers are effective in supporting prophylaxis delivery. An average of 101 cases of ARF were notified each year between 1995 and 2000, a rate of 2.8 per 100 000 population. The annual rate among those aged 5-14 years was 13.8 per 100 000. In 2001, there were six programmes using register-based approaches to manage prophylaxis. Three further programmes provided a surveillance function without links to prophylaxis provision. Public health services operated the majority (7/9) of programmes. Management programmes have varying links with primary health care providers of recurrent ARF prophylaxis. One programme has been discontinued and three programmes re-established or enhanced in the last three years. Considerable variation exists in register roles and configuration. The effectiveness of recurrent ARF prevention programmes should be evaluated to help optimise management of recurrent ARF prophylaxis in New Zealand. Suspected ARF cases, either first or recurrent, should usually be referred to a paediatrician, cardiologist or adult internal medicine physician to confirm diagnosis, usually requiring echocardiography. Confirmed cases should be referred to a register-based ARF recurrence prevention programme for prophylaxis provision, if available. First and recurrent ARF cases are notifiable.
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