Taken from the BPSU 5th Annual Report 1990

Acute Rheumatic Fever

The incidence of Acute Rheumatic Fever (ARF) has fallen dramatically I n recent decades and the disorder is now rarely seen. However, during the mid-1980'a there were reports of outbreaks of ARF in several areas of the United States and subsequently similar reports emerged from Europe. In February 1988, under the auspices of the BPSU, all paediatricians in the British Isles were asked to report any new cases of ARF seen during 1987; only nine were reported. Case ascertainment via such retrospective reporting was felt to be unsatisfactory so a 12 month prospective study was undertaken during 1990 with the main aim of determining the annual incidence of ARF in children less than 16 years in the British Isles.

A total of 33 initial reports were received and information had been provided on 29 of these. In a preliminary analysis using the revised Jones criteria, 16 children were categorised as "most likely" ARF, a further five being possible cases. Four were considered not likely and the status of one was indeterminate. There were three duplicates. Of the 16 "most likely cases ", eight had carditis (diagnosis based on clinical findings only) seven had polyathritis and five had chorea.

On receipt of data from all reported cases, the study was to describe ARF reported to the BPSU by paediatricians in the British Isles in 19900 in terms of numbers, age, sex, ethnicity of those affected, also clinical characteristics and those presumed antecedent streptococcal infection.(unfortunately this data is not available to this report).

It was hoped that a comparison of the reported cases with the returns from the Kormer data sets would provide an index of the usefulness of the latter as a source of these data. The preliminary analysis suggested that there are a number of cases in whim there is an overlap between "classic" ARF and the increasingly recognised entity of post-streptococcal reactive arthritis. The investigators had hoped to review the applicability of the Jones criteria in the light of the cases reported and to draw attention to the broader spectrum of post-streptococcal disease.