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Public health and economic perspectives on acute rheumatic fever and rheumatic heart disease

Jeffrey Cannon, Dawn C Bessarab, Rosemary Wyber and Judith M Katzenellenbogen
Med J Aust 2019; 211 (6): . || doi: 10.5694/mja2.50318
Published online: 16 September 2019

With the care costs for the thousands of new cases predicted to occur by 2031, can we afford “business as usual”?

The group A streptococcus (GAS) bacterium causes possibly the most diverse range of diseases compared with any other pathogen. Resulting from an autoimmune reaction to GAS throat infection, and possibly skin infection, acute rheumatic fever (ARF) and its common consequence of rheumatic heart disease (RHD) have been described as “diseases of poverty” because they are highly prevalent in socio‐economic disadvantaged settings.1 Although there is a clear gradient between disease prevalence and socio‐economic disadvantage, ARF and RHD were once also prevalent in low and high socio‐economic settings, including in Melbourne, among non‐Indigenous Australians during the 1930s and 1940s.2 That ARF rarely, if at all, occurs in modern Melbourne is testament to the reality that ARF and RHD can be eliminated Australia‐wide, but what will elimination of ARF and RHD take and can we afford “business as usual”?

  • Jeffrey Cannon1
  • Dawn C Bessarab2
  • Rosemary Wyber3
  • Judith M Katzenellenbogen4,5

  • 1 Telethon Kids Institute, Perth, WA
  • 2 Centre for Aboriginal Medical and Dental Health, University of Western Australia, Perth, WA
  • 3 George Institute for Global Health, Sydney, NSW
  • 4 Western Australian Centre for Rural Health, University of Western Australia, Perth, WA
  • 5 Group A Streptococcus and Rheumatic Heart Disease Research Group, Telethon Kids Institute, Perth, WA


Competing interests:

No relevant disclosures.

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